Dataset Information

Long-term impact of COVID-19 among maintenance haemodialysis patients.

ABSTRACT:

Background

Maintenance haemodialysis (MHD) patients have a high risk of initial mortality from coronavirus disease 2019 (COVID-19). However, long-term consequences of this disease in the MHD population are poorly described. We report the clinical presentation, outcome and long-term follow-up of MHD patients affected by COVID-19 in a multicentric cohort from the Paris, France area.

Methods

We conducted a retrospective analysis of clinical presentation and long-term follow-up of MHD patients affected by COVID-19 in 19 MHD centres in the Paris, France area.

Results

In this cohort of 248 patients with an initial mortality rate of 18%, age, comorbidities, dyspnoea and previous immunosuppressive treatment were associated with death at <30 days. Among the 203 surviving patients following the acute phase, long-term follow-up (median 180 days) was available for 189 (93%) patients. Major adverse events occurred in 30 (16%) patients during follow-up, including 12 deaths (6%) after a median of 78 days from onset of symptoms. Overall, cardiovascular events, infections and gastrointestinal bleeding were the main major adverse events. Post-COVID-19 cachexia was observed in 25/189 (13%) patients. Lower initial albuminaemia was significantly associated with this cachexia. No reinfection with severe acute respiratory syndrome coronavirus 2 was observed.

Conclusions

This work demonstrates the long-term consequences of COVID-19 in MHD patients, highlighting both initial and long-term severity of the disease, including severe cachexia.

SUBMITTER: Chawki S

PROVIDER: S-EPMC8522382 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Publications

Long-term impact of COVID-19 among maintenance haemodialysis patients.

Chawki Sylvain S Buchard Albert A Sakhi Hamza H Dardim Karim K El Sakhawi Karim K Chawki Mokhtar M Boulanger Henri H Kofman Tomek T Dahmane Djamal D Rieu Philippe P Attaf David D Ahriz-Saksi Salima S Masoumi Afshin A Diddaoui Ali Zineddine AZ Fromentin Luc L Michaut Patrick P Nebbad Rachida R Desassis Jean-François JF Nicolet Laurence L Sohier-Attias Julie J Besson Frederic F Boula Remy R Hafi Ali A Ghazali Abderrahmane A Lamriben Larbi L Arezki Adem A Dupuis Emmanuel E Rifard Mohamad-Khair MK Joly Dominique D Attias Philippe P El Karoui Khalil K

Clinical kidney journal 20210927 2

<h4>Background</h4>Maintenance haemodialysis (MHD) patients have a high risk of initial mortality from coronavirus disease 2019 (COVID-19). However, long-term consequences of this disease in the MHD population are poorly described. We report the clinical presentation, outcome and long-term follow-up of MHD patients affected by COVID-19 in a multicentric cohort from the Paris, France area.<h4>Methods</h4>We conducted a retrospective analysis of clinical presentation and long-term follow-up of MHD ...[more]

PMID: 35140935

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Project description:BackgroundPre-haemodialysis (HD) serum creatinine levels are reliable and inexpensive markers of muscle mass and important predictors of survival in patients with stable chronic HD. We aimed to assess whether changes in pre-HD serum creatinine levels during a 2-year period are linked to long-term patient survival.MethodsWe retrospectively analysed patients enrolled in a periodic HD quality assessment program. Of the 21 846 participants in the fourth HD quality assessment program, 13 765 were presented in the fifth, of which 10 299 eligible patients were included in this study. We assessed the change in serum creatinine levels over 2 years. The patients were categorized into the following three groups: stable group (patients with change in serum creatinine < 1 mg/dL during 2 years of HD, n = 5664), increasing group (patients with increase in serum creatinine ≥ 1 mg/dL, n = 2419) and decreasing group (patients with decrease in serum creatinine ≥ 1 mg/dL, n = 2216).ResultsThe duration of HD at baseline was 62-83 months, with diabetic kidney disease being the most common cause of kidney failure in 36.4% of patients. The 5-year patient survival rates in the stable, increasing and decreasing groups were 69.1%, 71.3% and 66.8%, respectively. The decreasing group had poorer patient survival than the other two groups (P = 0.083 for stable vs. increasing group; P = 0.011 for stable vs. decreasing group; P < 0.001 for increasing vs. decreasing group). There was no significant difference in the cardiovascular event-free survival rate among the three groups. Multivariable Cox regression analyses revealed the highest hazard ratio (HR) for mortality in the decreasing group (HR 1.33, 95% confidence interval [CI] 1.21-1.45, P < 0.001 vs. stable group; HR 1.50, 95% CI 1.34-1.69, P < 0.001 vs. increasing group). The increasing group exhibited a lower risk of mortality than the stable group (HR 0.88, 95% CI 0.81-0.97, P = 0.008). Subgroup analyses based on age, HD vintage, sex, Charlson comorbidity index score, presence of diabetes and baseline serum creatinine level tertiles revealed that the decreasing group exhibited the highest mortality among all subgroups.ConclusionsOur results demonstrate that changes in pre-HD serum creatinine levels over 2 years of HD were associated with all-cause mortality in patients undergoing HD. This finding suggests a simple and promising approach for clinicians in the prognosis and management of patients undergoing HD.

Dataset Information

Long-term impact of COVID-19 among maintenance haemodialysis patients.

Background

Methods

Results

Conclusions

Publications

Long-term impact of COVID-19 among maintenance haemodialysis patients.

Similar Datasets

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