1. Characteristics and outcomes of hospitalised older patients with chronic kidney disease and COVID‐19: A multicenter nationwide controlled study
- Author
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Numan Gorgulu, Ekrem Kara, Bulent Tokgoz, Dilek Guven Taymez, Halil Zeki Tonbul, Ender Hur, Murside Esra Dolarslan, İrem Pembegül, Mustafa Arici, Zubeyde Serhan Tuglular, İdris Şahin, Mahmud Islam, Alaattin Yildiz, Gülizar Şahin, Taner Basturk, Kenan Ates, Mehmet Riza Altiparmak, Zeki Aydin, Mahmut Gok, Hamad Dheir, Zeki Soypacaci, Serhat Karadag, Siren Sezer, Necmi Eren, Kenan Turgutalp, Garip Sahin, Ali Riza Odabas, Serkan Bakirdogen, Barış Döner, Mehmet Deniz Ayli, Tuba Elif Ozler, Melike Betul Ogutmen, Savas Ozturk, Erkan Sengul, RTEÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kara, Ekrem, Pembegül, İrem, Ozturk, Savas, Turgutalp, Kenan, Arici, Mustafa, Gok, Mahmut, Islam, Mahmud, Altiparmak, Mehmet Riza, Aydin, Zeki, Doner, Baris, Eren, Necmi, Sengul, Erkan, Karadag, Serhat, Ozler, Tuba Elif, Dheir, Hamad, Pembegul, Irem, Taymez, Dilek Guven, Sahin, Garip, Bakirdogen, Serkan, Dolarslan, Murside Esra, Soypacaci, Zeki, Hur, Ender, Basturk, Taner, Ogutmen, Melike Betul, Gorgulu, Numan, Sahin, Idris, Ayli, Mehmet Deniz, Tuglular, Zubeyde Serhan, Sahin, Gulizar, Tokgoz, Bulent, Tonbul, Halil Zeki, Yildiz, Alaattin, Sezer, Siren, Odabas, Ali Riza, and Ates, Kenan
- Subjects
Nephrology ,HEMODIALYSIS ,medicine.medical_treatment ,kidney disease ,Renal-diasease ,030204 cardiovascular system & hematology ,law.invention ,0302 clinical medicine ,COVID-19 Testing ,law ,Risk Factors ,INFECTION ,030212 general & internal medicine ,POPULATION ,RISK ,Mortality rate ,Hazard ratio ,DEATH ,General Medicine ,Middle Aged ,Intensive care unit ,Original Papers ,Death ,Hospitalization ,Hemodialysis ,Female ,Covid-19 ,Infection ,Risk ,medicine.medical_specialty ,Population ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Mortality ,Renal Insufficiency, Chronic ,Aged ,Retrospective Studies ,Original Paper ,business.industry ,SARS-CoV-2 ,MORTALITY ,COVID-19 ,Retrospective cohort study ,medicine.disease ,Confidence interval ,RENAL-DISEASE ,business ,Renal-Disease ,Kidney disease - Abstract
Objective Older adults with co‐morbidities have been reported to be at higher risk for adverse outcomes of coronavirus disease 2019 (COVID‐19). The characteristics of COVID‐19 in older patients and its clinical outcomes in different kidney disease groups are not well known. Methods Data were retrieved from a national multicentric database supported by Turkish Society of Nephrology, which consists of retrospectively collected data between 17 April 2020 and 31 December 2020. Hospitalised patients aged 18 years or older with confirmed COVID‐19 diagnosis suffering from stage 3‐5 chronic kidney disease (CKD) or on maintenance haemodialysis (HD) treatment were included in the database. Non‐uraemic hospitalised patients with COVID‐19 were also included as the control group. Results We included 879 patients [388 (44.1%) female, median age: 63 (IQR: 50‐73) years]. The percentage of older patients in the CKD group was 68.8% (n = 188/273), in the HD group was 49.0% (n = 150/306) and in the control group was 30.4% (n = 70/300). Co‐morbidities were higher in the CKD and HD groups. The rate of presentation with severe‐critical disease was higher in the older CKD and HD groups (43.6%, 55.3% and 16.1%, respectively). Among older patients, the intensive care unit (ICU) admission rate was significantly higher in the CKD and HD groups than in the control group (38.8%, 37.3% and 15.7%, respectively). In‐hospital mortality or death and/or ICU admission rates in the older group were significantly higher in the CKD (29.3% and 39.4%) and HD groups (26.7% and 30.1%) compared with the control group (8.6% and 17.1%). In the multivariate analysis, in‐hospital mortality rates in CKD and HD groups were higher than control group [hazard ratio (HR): 4.33 (95% confidence interval [CI]: 1.53‐12.26) and HR: 3.09 (95% CI: 1.04‐9.17), respectively]. Conclusion Among older COVID‐19 patients, in‐hospital mortality is significantly higher in those with stage 3‐5 CKD and on maintenance HD than older patients without CKD regardless of demographic characteristics, co‐morbidities, clinical and laboratory data on admission.
- Published
- 2021