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    • In-Hospital Mortality in Patients with ESRD Undergoing Hemodialysis Admitted with COVID-19 Compared to Those Without COVID-19

    Laura Aponte Becerra, Jhoan B. Rozas,Carlos A. Torres, Patrick Francois,Juanly N. Rodriguez,Juan D. Salcedo Betancourt, Abraham Santana Rodriguez, Maria Ortiz,Alessia Fornoni,Gabriel Contreras,Jair Munoz Mendoza

    Journal of the American Society of Nephrology（2021）SCI 1区

    University of Miami School of Medicine | Jackson Memorial Hospital | University of Miami Katz Family Division of Nephrology and Hypertension

    Cited 0|Views5
    Abstract
    Background: Patients with end-stage renal disease (ESRD) undergoing chronic hemodialysis (HD) have higher cardiovascular and infection-related death compared to the general population. ESRD patients have many of the comorbidities associated with COVID-19-related death, are at increased risk for severe COVID-19, and have higher COVID-19-related mortality. Whether patients with ESRD and COVID-19 have higher in-patient mortality than patients with ESRD without COVID-19 is unknown. Methods: Retrospective chart review of hospital admissions due to COVID-19 infection or those with ESRD admitted for any other reason between March to June 2020. We collected data on demographics, comorbidities, hospital length of stay, ICU utilization, and mortality. We categorized patients in three groups: ESRD with COVID-19, ESRD without COVID-19, and COVID-19 without ESRD. Mortality analysis was performed using Pearson's Chi-Square and logistic regression analysis. Results: A total of 494 patients with a mean age of 64 years were included, of which 55% were males, 33% were African American, 55% were Hispanic, 49% had hypertension, and 49% had diabetes. 20 patients had ESRD with COVID-19, 195 had ESRD without COVID-19, and 279 had COVID-19 without ESRD. The crude in-hospital mortality rate was 25% in patients with ESRD and COVID-19, 18% in patients with ESRD without COVID19, and 15% in those with COVID-19 without ESRD (p=0.465 for all comparisons). In multivariable logistic regression analyses, the adjusted odds ratio [OR] for in-hospital mortality in patients with ESRD with COVID-19 was 1.46 [95% confidence interval (CI), 0.77-2.80], the OR in patients with ESRD without COVID19 was 1.02 [95% CI, 0.73-1.42], as compared to patients with COVID-19 without ESRD. Conclusions: In-hospital mortality in patients with ESRD with COVID-19 is higher but not significantly different than in patients with ESRD without COVID-19 or than in those with COVID19 without ESRD. Further studies should evaluate the long-term COVID-19-related mortality in patients with ESRD.
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    【要点】：研究比较了ESRD患者并发COVID-19与不并发COVID-19以及非ESRD患者并发COVID-19的住院死亡率，发现ESRD患者并发COVID-19的住院死亡率较高但无显著差异。
    

    【方法】：通过回顾性病历审查，收集了患者的人口学数据、合并症、住院时长、ICU使用情况和死亡率，并使用Pearson's Chi-Square和logistic回归分析进行死亡率分析。
    

    【实验】：研究在2020年3月至6月间对494名患者进行了分析，其中包括20名ESRD并发COVID-19患者、195名ESRD不并发COVID-19患者和279名非ESRD并发COVID-19患者，数据集未明确提及。结果显示，ESRD并发COVID-19患者的住院粗死亡率为25%，ESRD不并发COVID-19患者的住院粗死亡率为18%，非ESRD并发COVID-19患者的住院粗死亡率为15%，差异不显著。