Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease

Pilgram L, Eberwein L, Wille K, Koehler FC, Stecher M, Rieg S, Kielstein JT, Jakob CEM, Ruthrich M, Burst V, Prasser F, Borgmann S, Mueller RU, Lanznaster J, Isberner N, Tometten L, Dolff S (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Infection Springer Verlag (Germany)

Book Volume: 49

Pages Range: 725-737

Journal Issue: 4

DOI: 10.1007/s15010-021-01597-7

Abstract

Purpose: The ongoing pandemic caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2) has stressed health systems worldwide. Patients with chronic kidney disease (CKD) seem to be more prone to a severe course of coronavirus disease (COVID-19) due to comorbidities and an altered immune system. The study’s aim was to identify factors predicting mortality among SARS-CoV-2-infected patients with CKD. Methods: We analyzed 2817 SARS-CoV-2-infected patients enrolled in the Lean European Open Survey on SARS-CoV-2-infected patients and identified 426 patients with pre-existing CKD. Group comparisons were performed via Chi-squared test. Using univariate and multivariable logistic regression, predictive factors for mortality were identified. Results: Comparative analyses to patients without CKD revealed a higher mortality (140/426, 32.9% versus 354/2391, 14.8%). Higher age could be confirmed as a demographic predictor for mortality in CKD patients (> 85 years compared to 15–65 years, adjusted odds ratio (aOR) 6.49, 95% CI 1.27–33.20, p = 0.025). We further identified markedly elevated lactate dehydrogenase (> 2 × upper limit of normal, aOR 23.21, 95% CI 3.66–147.11, p < 0.001), thrombocytopenia (< 120,000/µl, aOR 11.66, 95% CI 2.49–54.70, p = 0.002), anemia (Hb < 10 g/dl, aOR 3.21, 95% CI 1.17–8.82, p = 0.024), and C-reactive protein (≥ 30 mg/l, aOR 3.44, 95% CI 1.13–10.45, p = 0.029) as predictors, while renal replacement therapy was not related to mortality (aOR 1.15, 95% CI 0.68–1.93, p = 0.611). Conclusion: The identified predictors include routinely measured and universally available parameters. Their assessment might facilitate risk stratification in this highly vulnerable cohort as early as at initial medical evaluation for SARS-CoV-2.

Additional Organisation(s)

Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology

Involved external institutions

Universität zu Köln DE Germany (DE) Goethe-Universität Frankfurt am Main DE Germany (DE) Ruhr-Universität Bochum (RUB) DE Germany (DE) Klinikum Passau DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Klinikum Leverkusen DE Germany (DE) Klinikum Ernst von Bergmann DE Germany (DE) Julius-Maximilians-Universität Würzburg DE Germany (DE) Universität Duisburg-Essen (UDE) DE Germany (DE) Klinikum Ingolstadt DE Germany (DE) Städtisches Klinikum Braunschweig DE Germany (DE) Universitätsklinikum Jena DE Germany (DE) Albert-Ludwigs-Universität Freiburg DE Germany (DE)

How to cite

APA:

Pilgram, L., Eberwein, L., Wille, K., Koehler, F.C., Stecher, M., Rieg, S.,... Dolff, S. (2021). Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease. Infection, 49(4), 725-737. https://doi.org/10.1007/s15010-021-01597-7

MLA:

Pilgram, Lisa, et al. "Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease." Infection 49.4 (2021): 725-737.

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