Hemodializ Hastalarında COVID-19'un klinik seyri ve mortalite öngördürücüleri, tek merkez deneyimi

Oğuz Evlice; Damla Örs Şendoğan; Öznur Ak

doi:10.34084/bshr.929708

Research Article

Hemodializ Hastalarında COVID-19'un klinik seyri ve mortalite öngördürücüleri, tek merkez deneyimi

Year 2021, Volume: 5 Issue: 2, 105 - 112, 01.09.2021

Oğuz Evlice Damla Örs Şendoğan Öznur Ak

https://doi.org/10.34084/bshr.929708

Cited By: 1

Abstract

Özet
Giriş
Altta yatan sağlık sorunları ya da komorbiditesi olan COVİD-19 tanılı hastalar, hızlı ve şiddetli progresyon gösterme eğilimindedir. Hemodializ hastalarında üremi nedeniyle baskılanmış immun sistemleri ve eşlik eden hipertansiyon (HT), diyabetes mellitus (DM) ve koroner arter hastalığı (KAH) gibi komorbiditeleri hastalığın ağır seyretmesi için risk oluşturmaktadır. Bu çalışmada COVİD-19 tanısıyla takip edilen hemodializ hastalarının klinik ve laboratuar bulgularını ve prognozu etkileyen risk faktörlerini irdelemeyi amaçladık.
Method
01.08.2020-15.11.2020 tarihleri arasında klinik, laboratuar ve radyolojik bulgularla COVID-19 tanısı konulan 58 erişkin hemodializ hastası retrospektif olarak değerlendirildi.
Bulgular
Çalışmaya dahil edilen 58 hastanın 37'si (% 63.8) erkekti. 54’ünde (%93.1) SARS-CoV-2 PCR testi pozitifti. 4 hastanın (%6,9) PCR testi negatif saptandı, ancak radyolojik ve klinik bulguları COVID-19 pnömonisiyle uyumluydu. En sık görülen semptomlar halsizlik/vücut ağrısı, nefes darlığı ve öksürük, en sık komorbiditeler sırasıyla HT, DM ve koroner arter hastalığıydı. Hastaların 47’si (%81) hayatta kalırken, 11’i (%19) mortalite ile sonlandı. Mortalite ile sonlanan olgular ile sağ kalan olgular karşılaştırıldığında mortalite olan olgularda başvuru esnasında vücut ısısının daha yüksek, oksijen satürasyonunun (p:0,02) , lenfosit sayısının daha düşük olduğu (p:0,03) ve akciğer tomografisinde daha şiddetli tutulum bulguları saptandı. Hastaların tümünde antiviral , destek tedavi yaklaşımı benzer iken mortalite gelişen grupta daha fazla ampirik olarak geniş spektrumlu antibiyotikle birlikte ve kortikosteorid kullanımı saptandı (p<0.05).

Sonuç

Başvuru anındaki ateşin daha yüksek olması, oksijen satürasyonu değerlerinin daha düşük olması, lenfopeninin derinliği, akciğer radyolojisinde bilateral şiddetli tutulum varlığı kötü prognoz açısından anlamlı prognostik faktörler olarak bulundu.

Keywords

COVID-19, SARS-CoV-2, hemodiyaliz, mortalite, prognostik faktör

References

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8)Vijayan A, Boyce JM. 100% Use of Infection Control Procedures in Hemodialysis Facilities: Call to Action. Clin J Am Soc Nephrol. 2018 Apr 6;13(4):671-673. doi: 10.2215/CJN.11341017. Epub 2018 Mar 22. PMID: 29567863; PMCID: PMC5968911
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10) Oto OA, Ozturk S, Turgutalp K, Arici M, Alpay N, Merhametsiz O, Sipahi S, Ogutmen MB, Yelken B, Altiparmak MR, Gorgulu N, Tatar E, Ozkan O, Ayar Y, Aydin Z, Dheir H, Ozkok A, Safak S, Demir ME, Odabas AR, Tokgoz B, Tonbul HZ, Sezer S, Ates K, Yildiz A. Predicting the outcome of COVID-19 infection in kidney transplant recipients. BMC Nephrol. 2021 Mar 19;22(1):100. doi: 10.1186/s12882-021-02299-w. PMID: 33740915; PMCID: PMC7977489.
11)Valeri AM, Robbins-Juarez SY, Stevens JS, Ahn W, Rao MK, Radhakrishnan J, Gharavi AG, Mohan S, Husain SA. Presentation and Outcomes of Patients with ESKD and COVID-19. J Am Soc Nephrol. 2020 Jul;31(7):1409-1415. doi: 10.1681/ASN.2020040470. Epub 2020 May 28. PMID: 32467113; PMCID: PMC7350989.
12) Goicoechea M, Sánchez Cámara LA, Macías N, Muñoz de Morales A, Rojas ÁG, Bascuñana A, Arroyo D, Vega A, Abad S, Verde E, García Prieto AM, Verdalles Ú, Barbieri D, Delgado AF, Carbayo J, Mijaylova A, Acosta A, Melero R, Tejedor A, Benitez PR, Pérez de José A, Rodriguez Ferrero ML, Anaya F, Rengel M, Barraca D, Luño J, Aragoncillo I. COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Kidney Int. 2020 Jul;98(1):27-34. doi: 10.1016/j.kint.2020.04.031. Epub 2020 May 11. PMID: 32437770; PMCID: PMC7211728.
13)Zhu J, Ji P, Pang J, Zhong Z, Li H, He C, Zhang J, Zhao C. Clinical characteristics of 3062 COVID-19 patients: A meta-analysis. J Med Virol. 2020 Oct;92(10):1902-1914. doi: 10.1002/jmv.25884. Epub 2020 Jun 24. PMID: 32293716; PMCID: PMC7262119.
14) Stefan G, Mehedinti AM, Andreiana I, Zugravu AD, Cinca S, Busuioc R, Miler I, Stancu S, Petrescu L, Dimitriu I, Moldovanu E, Crasnaru DE, Gugonea G, Georgescu V, Strambu VD, Capusa C. Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania. Ren Fail. 2021 Dec;43(1):49-57. doi: 10.1080/0886022X.2020.1853571. PMID: 33307933.
15) Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. J Intensive Care. 2020 May 24;8:36. doi: 10.1186/s40560-020-00453-4. PMID: 32483488; PMCID: PMC7245646.
16) Bahl A, Van Baalen MN, Ortiz L, Chen NW, Todd C, Milad M, Yang A, Tang J, Nygren M, Qu L. Early predictors of in-hospital mortality in patients with COVID-19 in a large American cohort. Intern Emerg Med. 2020 Nov;15(8):1485-1499. doi: 10.1007/s11739-020-02509-7. Epub 2020 Sep 24. PMID: 32970246; PMCID: PMC7512216.
17)Xiong F, Tang H, Liu L, Tu C, Tian JB, Lei CT, Liu J, Dong JW, Chen WL, Wang XH, Luo D, Shi M, Miao XP, Zhang C. Clinical Characteristics of and Medical Interventions for COVID-19 in Hemodialysis Patients in Wuhan, China. J Am Soc Nephrol. 2020 Jul;31(7):1387-1397. doi: 10.1681/ASN.2020030354. Epub 2020 May 8. PMID: 32385130; PMCID: PMC7350995.
18)Dexamethasone for COVID-19: preliminary findings. Drug Ther Bull. 2020 Sep;58(9):133. doi: 10.1136/dtb.2020.000045. Epub 2020 Jul 20. PMID: 32690491.
19) Zou R, Chen F, Chen D, Xu CL, Xiong F. Clinical characteristics and outcome of hemodialysis patients with COVID-19: a large cohort study in a single Chinese center. Ren Fail. 2020;42(1):950-957. doi:10.1080/0886022X.2020.1816179
20) Langford BJ, So M, Raybardhan S, Leung V, Westwood D, MacFadden DR, Soucy JR, Daneman N. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clin Microbiol Infect. 2020 Dec;26(12):1622-1629. doi: 10.1016/j.cmi.2020.07.016. Epub 2020 Jul 22. PMID: 32711058; PMCID: PMC7832079.
21) Xie J, Covassin N, Fan Z, Singh P, Gao W, Li G, Kara T, Somers VK. Association Between Hypoxemia and Mortality in Patients With COVID-19. Mayo Clin Proc. 2020 Jun;95(6):1138-1147. doi: 10.1016/j.mayocp.2020.04.006. Epub 2020 Apr 11. PMID: 32376101; PMCID: PMC7151468.

Year 2021, Volume: 5 Issue: 2, 105 - 112, 01.09.2021

Oğuz Evlice Damla Örs Şendoğan Öznur Ak

https://doi.org/10.34084/bshr.929708

Cited By: 1

Abstract

References

1) Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W; China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020 Feb 20;382(8):727-733. doi: 10.1056/NEJMoa2001017. Epub 2020 Jan 24. PMID: 31978945; PMCID: PMC7092803.
2) Fajgenbaum DC, June CH. Cytokine Storm. N Engl J Med. 2020 Dec 3;383(23):2255-2273. doi: 10.1056/NEJMra2026131. PMID: 33264547; PMCID: PMC7727315.
3) Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, Hosein Z, Padda I, Mangat J, Altaf M. Comorbidity and its Impact on Patients with COVID-19. SN Compr Clin Med. 2020 Jun 25:1-8. doi: 10.1007/s42399-020-00363-4. Epub ahead of print. PMID: 32838147; PMCID: PMC7314621.
4)Vaziri ND, Pahl MV, Crum A, Norris K. Effect of uremia on structure and function of immune system. J Ren Nutr. 2012 Jan;22(1):149-56. doi: 10.1053/j.jrn.2011.10.020. PMID: 22200433; PMCID: PMC3246616
5) Organization, W. H. (2020). Global surveillance for COVID-19 caused by human infection with COVID-19 virus: interim guidance 2 Probable case. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-
6)British Society of Thoracic Imaging. Thoracic Imaging in COVID-19 Infection. Guidance for the Reporting Radiologist. Version 2. 16th March 2020 [İnternet]. UK: BSTI [erişim 13 Mart2020].https://www.bsti.org.uk/media/resources/files/BSTI_COVID 19_Radiology_Guidance_version_2_16.03.20.pdf.
7) Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24. Erratum in: Lancet. 2020 Jan 30;: PMID: 31986264; PMCID: PMC7159299.
8)Vijayan A, Boyce JM. 100% Use of Infection Control Procedures in Hemodialysis Facilities: Call to Action. Clin J Am Soc Nephrol. 2018 Apr 6;13(4):671-673. doi: 10.2215/CJN.11341017. Epub 2018 Mar 22. PMID: 29567863; PMCID: PMC5968911
9)Wong PN, Mak SK, Lo KY, Tong GM, Wong Y, Watt CL, Wong AK. Clinical presentation and outcome of severe acute respiratory syndrome in dialysis patients. Am J Kidney Dis. 2003 Nov;42(5):1075-81. doi: 10.1016/j.ajkd.2003.08.005. PMID: 14582052; PMCID: PMC7115733.
10) Oto OA, Ozturk S, Turgutalp K, Arici M, Alpay N, Merhametsiz O, Sipahi S, Ogutmen MB, Yelken B, Altiparmak MR, Gorgulu N, Tatar E, Ozkan O, Ayar Y, Aydin Z, Dheir H, Ozkok A, Safak S, Demir ME, Odabas AR, Tokgoz B, Tonbul HZ, Sezer S, Ates K, Yildiz A. Predicting the outcome of COVID-19 infection in kidney transplant recipients. BMC Nephrol. 2021 Mar 19;22(1):100. doi: 10.1186/s12882-021-02299-w. PMID: 33740915; PMCID: PMC7977489.
11)Valeri AM, Robbins-Juarez SY, Stevens JS, Ahn W, Rao MK, Radhakrishnan J, Gharavi AG, Mohan S, Husain SA. Presentation and Outcomes of Patients with ESKD and COVID-19. J Am Soc Nephrol. 2020 Jul;31(7):1409-1415. doi: 10.1681/ASN.2020040470. Epub 2020 May 28. PMID: 32467113; PMCID: PMC7350989.
12) Goicoechea M, Sánchez Cámara LA, Macías N, Muñoz de Morales A, Rojas ÁG, Bascuñana A, Arroyo D, Vega A, Abad S, Verde E, García Prieto AM, Verdalles Ú, Barbieri D, Delgado AF, Carbayo J, Mijaylova A, Acosta A, Melero R, Tejedor A, Benitez PR, Pérez de José A, Rodriguez Ferrero ML, Anaya F, Rengel M, Barraca D, Luño J, Aragoncillo I. COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Kidney Int. 2020 Jul;98(1):27-34. doi: 10.1016/j.kint.2020.04.031. Epub 2020 May 11. PMID: 32437770; PMCID: PMC7211728.
13)Zhu J, Ji P, Pang J, Zhong Z, Li H, He C, Zhang J, Zhao C. Clinical characteristics of 3062 COVID-19 patients: A meta-analysis. J Med Virol. 2020 Oct;92(10):1902-1914. doi: 10.1002/jmv.25884. Epub 2020 Jun 24. PMID: 32293716; PMCID: PMC7262119.
14) Stefan G, Mehedinti AM, Andreiana I, Zugravu AD, Cinca S, Busuioc R, Miler I, Stancu S, Petrescu L, Dimitriu I, Moldovanu E, Crasnaru DE, Gugonea G, Georgescu V, Strambu VD, Capusa C. Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania. Ren Fail. 2021 Dec;43(1):49-57. doi: 10.1080/0886022X.2020.1853571. PMID: 33307933.
15) Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. J Intensive Care. 2020 May 24;8:36. doi: 10.1186/s40560-020-00453-4. PMID: 32483488; PMCID: PMC7245646.
16) Bahl A, Van Baalen MN, Ortiz L, Chen NW, Todd C, Milad M, Yang A, Tang J, Nygren M, Qu L. Early predictors of in-hospital mortality in patients with COVID-19 in a large American cohort. Intern Emerg Med. 2020 Nov;15(8):1485-1499. doi: 10.1007/s11739-020-02509-7. Epub 2020 Sep 24. PMID: 32970246; PMCID: PMC7512216.
17)Xiong F, Tang H, Liu L, Tu C, Tian JB, Lei CT, Liu J, Dong JW, Chen WL, Wang XH, Luo D, Shi M, Miao XP, Zhang C. Clinical Characteristics of and Medical Interventions for COVID-19 in Hemodialysis Patients in Wuhan, China. J Am Soc Nephrol. 2020 Jul;31(7):1387-1397. doi: 10.1681/ASN.2020030354. Epub 2020 May 8. PMID: 32385130; PMCID: PMC7350995.
18)Dexamethasone for COVID-19: preliminary findings. Drug Ther Bull. 2020 Sep;58(9):133. doi: 10.1136/dtb.2020.000045. Epub 2020 Jul 20. PMID: 32690491.
19) Zou R, Chen F, Chen D, Xu CL, Xiong F. Clinical characteristics and outcome of hemodialysis patients with COVID-19: a large cohort study in a single Chinese center. Ren Fail. 2020;42(1):950-957. doi:10.1080/0886022X.2020.1816179
20) Langford BJ, So M, Raybardhan S, Leung V, Westwood D, MacFadden DR, Soucy JR, Daneman N. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clin Microbiol Infect. 2020 Dec;26(12):1622-1629. doi: 10.1016/j.cmi.2020.07.016. Epub 2020 Jul 22. PMID: 32711058; PMCID: PMC7832079.
21) Xie J, Covassin N, Fan Z, Singh P, Gao W, Li G, Kara T, Somers VK. Association Between Hypoxemia and Mortality in Patients With COVID-19. Mayo Clin Proc. 2020 Jun;95(6):1138-1147. doi: 10.1016/j.mayocp.2020.04.006. Epub 2020 Apr 11. PMID: 32376101; PMCID: PMC7151468.

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Details

Primary Language	Turkish
Subjects	Infectious Diseases
Journal Section	Research Article
Authors	Oğuz Evlice 0000-0001-6939-0367 Damla Örs Şendoğan 0000-0002-0167-8011 Öznur Ak 0000-0003-3790-3070
Publication Date	September 1, 2021
Acceptance Date	June 9, 2021
Published in Issue	Year 2021 Volume: 5 Issue: 2

Cite

AMA	Evlice O, Örs Şendoğan D, Ak Ö. Hemodializ Hastalarında COVID-19’un klinik seyri ve mortalite öngördürücüleri, tek merkez deneyimi. J Biotechnol and Strategic Health Res. September 2021;5(2):105-112. doi:10.34084/bshr.929708

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