Article ; Online: COVID-19 Among US Dialysis Patients: Risk Factors and Outcomes From a National Dialysis Provider.
American journal of kidney diseases : the official journal of the National Kidney Foundation
2021 Volume 77, Issue 5, Page(s) 748–756.e1
Abstract: ... characteristics associated with COVID-19 and risk factors associated with mortality among patients following COVID ... Of the 438 maintenance dialysis patients with COVID-19, 109 (24.9%) died. Older age, heart disease, and ... participants: Maintenance dialysis patients in clinics of a midsize national dialysis provider that had ...
| Abstract | Rationale & objective: During the coronavirus disease 2019 (COVID-19) pandemic, patients receiving maintenance dialysis are a highly vulnerable population due to their comorbidities and circumstances that limit physical distancing during treatment. This study sought to characterize the risk factors for and outcomes following COVID-19 in this population. Study design: Retrospective cohort study. Setting & participants: Maintenance dialysis patients in clinics of a midsize national dialysis provider that had at least 1 patient who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from February to June 2020. Predictors: Demographics, dialysis characteristics, residence in a congregated setting, comorbid conditions, measurements of frailty, and use of selected medications. Outcomes: COVID-19, defined as having a positive SARS-CoV-2 test result, and all-cause mortality among those with COVID-19. Analytical approach: Logistic regression analyses conducted to identify clinical characteristics associated with COVID-19 and risk factors associated with mortality among patients following COVID-19. Results: 438 of 7948 (5.5%) maintenance dialysis patients developed COVID-19. Male sex, Black race, in-center dialysis (vs home dialysis), treatment at an urban clinic, residence in a congregate setting, and greater comorbidity were associated with contracting COVID-19. Odds of COVID-19 were 17-fold higher for those residing in a congregated setting (odds ratio [OR], 17.10 [95% CI, 13.51-21.54]). Of the 438 maintenance dialysis patients with COVID-19, 109 (24.9%) died. Older age, heart disease, and markers of frailty were associated with mortality. Limitations: No distinction was detected between symptomatic and asymptomatic SARS-CoV-2 positivity, with asymptomatic screening limited by testing capacity during this initial COVID-19 surge period. Conclusions: COVID-19 is common among patients receiving maintenance dialysis, particularly those residing in congregate settings. Among maintenance dialysis patients with COVID-19, mortality is high, exceeding 20%. |
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| MeSH term(s) | Age Factors ; Aged ; COVID-19/mortality ; COVID-19/therapy ; Comorbidity ; Female ; Frailty/diagnosis ; Frailty/epidemiology ; Frailty/etiology ; Heart Diseases/epidemiology ; Humans ; Infection Control/methods ; Kidney Failure, Chronic/epidemiology ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Mortality ; Nursing Homes/statistics & numerical data ; Renal Dialysis/methods ; Renal Dialysis/statistics & numerical data ; Retrospective Studies ; Risk Assessment ; Risk Factors ; SARS-CoV-2/isolation & purification ; United States/epidemiology |
| Language | English |
| Publishing date | 2021-01-17 |
| Publishing country | United States |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 604539-x |
| ISSN | 1523-6838 ; 0272-6386 |
| ISSN (online) | 1523-6838 |
| ISSN | 0272-6386 |
| DOI | 10.1053/j.ajkd.2021.01.003 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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