Survival and predictive factors in dialysis patients with COVID-19 in Japan: a nationwide cohort study

Renal Replacement Therapy - 2021
Kan Kikuchi1, Masaomi Nangaku2, Munekazu Ryuzaki3, Tomoyuki Yamakawa4, Oota Yoshihiro5, Norio Hanafusa6, Ken Sakai7, Yoshihiko Kanno8, Ryoichi Ando9, Takeshi Shinoda10, Hidetomo Nakamoto11, Tadao Akizawa12
1Division of Nephrology, Shimoochiai Clinic, Tokyo, Japan
2Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
3Department of Nephrology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
4Kidney Center, Shirasagi Hospital, Osaka, Japan
5Nagoya Memorial Hospital, Nagoya, Japan
6Department of Blood Purification, Tokyo Women’s Medical University, Tokyo, Japan
7Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan
8Department of Nephrology, Tokyo Medical University, Tokyo, Japan
9Department of Nephrology, Seishokai Memorial Hospital, Tokyo, Japan
10Faculty of Medical and Health Sciences, Tsukuba International University, Tsuchiura, Japan
11Department of General Internal Medicine, Saitama Medical University, Iruma, Japan
12Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan

Tóm tắt

Abstract Background

The Japanese Association of Dialysis Physicians, the Japanese Society for Dialysis Therapy, and the Japanese Society of Nephrology jointly established COVID-19 Task Force Committee and began surveying the number of newly infected patients.

 Methods

This registry of the COVID-19 Task Force Committee was used to collect data of dialysis patients; a total of 1010 dialysis patients with COVID-19 were included in the analysis. Overall survival of patients was investigated with stratification by age group, complication status, and treatment. In addition, predictive factors for mortality were also investigated. The overall survival was estimated by Kaplan–Meier methods and compared by using log-rank test. Multivariate analysis was performed to identify the risk factor of mortality. For all statistical analyses, p < 0.05 was considered to be statistically significant.

 Results

The mortality risk was increased with age (p < 0.001). The mortality risk was significantly higher in patients with peripheral arterial disease (HR: 1.49, 95% CI 1.05–2.10) and significantly lower in patients who were treated with remdesivir (HR: 0.60, 95% CI 0.37–0.98). Multivariate analysis showed increased risk of mortality with increment in BMI, and increment in CRP, and decreased risk with increment in albumin.

 Conclusion

Dialysis patients have a high severity of illness and a high risk of mortality in cases of COVID-19. Treatment with remdesivir might be effective in shortening the duration of hospitalization and reducing the risk of mortality.

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Tài liệu tham khảo

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