Risk factors for COVID-19 hospitalization and mortality in patients with chronic kidney disease: a nationwide cohort study

被引:5
作者
Artborg, Angelica [1 ,2 ]
Caldinelli, Aurora [1 ,3 ]
Wijkstrom, Julia [1 ,2 ]
Nowak, Alexandra [1 ,2 ]
Fored, Michael [4 ]
Stendahl, Maria [5 ,6 ]
Evans, Marie [1 ,2 ,6 ]
Rydell, Helena [1 ,2 ,6 ]
机构
[1] Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden
[2] Karolinska Univ Hosp, Dept Renal Med, Stockholm, Sweden
[3] Univ Milano Bicocca, Dept Stat & Quantat Methods, Milan, Italy
[4] Karolinska Inst, Dept Med, Stockholm, Sweden
[5] Ryhov Hosp, Dept Internal Med, Jonkoping, Sweden
[6] Swedish Renal Register, Jonkoping, Sweden
关键词
CKD; COVID-19; dialysis; mortality; risk factors;
D O I
10.1093/ckj/sfad283
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background Several studies have demonstrated an increased risk of severe coronavirus disease 2019 (COVID-19) in chronic kidney disease (CKD) patients. However, few have investigated the impact of CKD stage and dialysis modality. The primary aim of this study was to investigate the association between CKD stage, dialysis modality and risk of severe COVID-19. Secondly, we aimed to study the impact of comorbidities and drugs on the risk of severe COVID-19 in the CKD population.Methods This nationwide observational study was based on data from the Swedish Renal Registry and three other national registries. Patients with non-dialysis CKD stage 3b-5 or dialysis on 1 January 2020 were included and followed until 31 December 2021. The primary outcome was COVID-19 hospitalization; the secondary outcome was COVID-19 mortality. Associations were investigated using logistic regression models, adjusting for confounders.Results The study population comprised 7856 non-dialysis CKD patients and 4018 dialysis patients. The adjusted odds ratios (aOR) for COVID-19 hospitalization and mortality were highest in the dialysis group [aOR 2.24, 95% confidence interval (CI) 1.79-2.81; aOR 3.10, Cl 95% 2.03-4.74], followed by CKD 4 (aOR 1.33, 95% CI 1.05-1.68; aOR 1.66, Cl 95% 1.07-2.57), as compared with CKD 3b. No difference in COVID-19 outcomes was observed between patients on hemodialysis and peritoneal dialysis. Overall comorbidity burden was one of the strongest risk factors for severe COVID-19 and the risk was also increased in patients prescribed insulin, proton pump inhibitors, diuretics, antiplatelets or immunosuppressants.Conclusions Worsening CKD stage and comorbidity are independent risk factors for severe COVID-19 in the Swedish CKD population.
引用
收藏
页数:10
相关论文
共 24 条
[1]   Mortality and readmission rates among hospitalized COVID-19 patients with varying stages of chronic kidney disease: a multicenter retrospective cohort [J].
Appelman, Brent ;
Oppelaar, Jetta J. ;
Broeders, Lani ;
Wiersinga, Willem Joost ;
Peters-Sengers, Hessel ;
Vogt, Liffert .
SCIENTIFIC REPORTS, 2022, 12 (01)
[2]   Increased vulnerability to COVID-19 in chronic kidney disease [J].
Carlson, N. ;
Nelveg-Kristensen, K-E ;
Ballegaard, E. Freese ;
Feldt-Rasmussen, B. ;
Hornum, M. ;
Kamper, A-Lise ;
Gislason, G. ;
Torp-Pedersen, C. .
JOURNAL OF INTERNAL MEDICINE, 2021, 290 (01) :166-178
[3]   Prognostic value of estimated glomerular filtration rate in hospitalised older patients (over 65) with COVID-19: a multicentre, European, observational cohort study [J].
Carter, Ben ;
Ramsay, Euan A. ;
Short, Roxanna ;
Goodison, Sarah ;
Lumsden, Jane ;
Khan, Amarah ;
Braude, Philip ;
Vilches-Moraga, Arturo ;
Quinn, Terence J. ;
McCarthy, Kathryn ;
Hewitt, Jonathan ;
Myint, Phyo K. .
BMC GERIATRICS, 2022, 22 (01)
[4]   Prediction of Mortality in Patients Undergoing Maintenance Hemodialysis by Charlson Comorbidity Index Using ICD-10 Database [J].
Chae, Je-Wook ;
Song, Chang Seok ;
Kim, Hyang ;
Lee, Kyu-Beck ;
Seo, Byeong-Sung ;
Kim, Dong-Il .
NEPHRON CLINICAL PRACTICE, 2011, 117 (04) :C379-C384
[5]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[6]   The Use of Proton Pump Inhibitors and COVID-19: A Systematic Review and Meta-Analysis [J].
Fatima, Kaneez ;
Almas, Talal ;
Lakhani, Shan ;
Jahangir, Arshia ;
Ahmed, Abdullah ;
Siddiqui, Ayra ;
Rahim, Aiman ;
Qureshi, Saleha Ahmed ;
Arshad, Zukhruf ;
Golani, Shilpa ;
Musheer, Adeena .
TROPICAL MEDICINE AND INFECTIOUS DISEASE, 2022, 7 (03)
[7]   COVID-19-related mortality in kidney transplant and dialysis patients: results of the ERACODA collaboration [J].
Hilbrands, Luuk B. ;
Duivenvoorden, Raphael ;
Vart, Priya ;
Franssen, Casper F. M. ;
Hemmelder, Marc H. ;
Jager, Kitty J. ;
Kieneker, Lyanne M. ;
Noordzij, Marlies ;
Pena, Michelle J. ;
de Vries, Hanne ;
Arroyo, David ;
Covic, Adrian ;
Crespo, Marta ;
Goffin, Eric ;
Islam, Mahmud ;
Massy, Ziad A. ;
Montero, Nuria ;
Oliveira, Joao P. ;
Roca Munoz, Ana ;
Sanchez, J. Emilio ;
Sridharan, Sivakumar ;
Winzeler, Rebecca ;
Gansevoort, Ron T. .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2020, 35 (11) :1973-1983
[8]   Aspects of immune dysfunction in end-stage renal disease [J].
Kato, Sawako ;
Chmielewski, Michal ;
Honda, Hirokazu ;
Pecoits-Filho, Roberto ;
Matsuo, Seiichi ;
Yuzawa, Yukio ;
Tranaeus, Anders ;
Stenvinkel, Peter ;
Lindholm, Bengt .
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2008, 3 (05) :1526-1533
[9]   A New Equation to Estimate Glomerular Filtration Rate [J].
Levey, Andrew S. ;
Stevens, Lesley A. ;
Schmid, Christopher H. ;
Zhang, Yaping ;
Castro, Alejandro F., III ;
Feldman, Harold I. ;
Kusek, John W. ;
Eggers, Paul ;
Van Lente, Frederick ;
Greene, Tom ;
Coresh, Josef .
ANNALS OF INTERNAL MEDICINE, 2009, 150 (09) :604-612
[10]   Can ACEIs and ARBs be safely continued in COVID-19:- The Evidence is here at Last! [J].
Velupandian, Uma .
HEART VIEWS, 2021, 22 (01) :2-2