Center for Experimental and Molecular Medicine, Amsterdam UMC, Amsterdam, The Netherlands.
The Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Amsterdam, The Netherlands.
Sci Rep. 2022 Feb 10;12(1):2258. doi: 10.1038/s41598-022-06276-7.
Chronic kidney disease (CKD) has been recognized as a highly prevalent risk factor for both the severity of coronavirus disease 2019 (COVID-19) and COVID-19 associated adverse outcomes. In this multicenter observational cohort study, we aim to determine mortality and readmission rates of patients hospitalized for COVID-19 across varying CKD stages. We performed a multicenter cohort study among COVID-19 patients included in the Dutch COVIDPredict cohort. The cohort consists of hospitalized patients from March 2020 until July 2021 with PCR-confirmed SARS-CoV-2 infection or a highly suspected CT scan-based infection with a CORADS score ≥ 4. A total of 4151 hospitalized COVID-19 patients were included of who 389 had a history of CKD before admission. After adjusting for all confounding covariables, in patients with CKD stage 3a, stage 3b, stage 4 and patients with KTX (kidney transplantation), odds ratios of death and readmission compared to patients without CKD ranged from 1.96 to 8.94. We demonstrate an evident increased 12-week mortality and readmission rate in patients with chronic kidney disease. Besides justified concerns for kidney transplant patients, clinicians should also be aware of more severe COVID-19 outcomes and increased vulnerability in CKD patients.
慢性肾脏病(CKD)已被认为是 2019 年冠状病毒病(COVID-19)严重程度和 COVID-19 相关不良结局的高度流行危险因素。在这项多中心观察性队列研究中,我们旨在确定不同 CKD 阶段 COVID-19 住院患者的死亡率和再入院率。我们对荷兰 COVIDPredict 队列中包括的 COVID-19 患者进行了多中心队列研究。该队列包括 2020 年 3 月至 2021 年 7 月期间因 PCR 确诊的 SARS-CoV-2 感染或高度疑似 CT 扫描感染(CORADS 评分≥4)住院的患者。共纳入 4151 例 COVID-19 住院患者,其中 389 例在入院前有 CKD 病史。在调整所有混杂协变量后,与无 CKD 患者相比,CKD 3a 期、3b 期、4 期和 KTX(肾移植)患者的死亡和再入院的比值比范围为 1.96 至 8.94。我们证明了慢性肾脏病患者的 12 周死亡率和再入院率明显增加。除了对肾移植患者的合理关注外,临床医生还应意识到 CKD 患者的 COVID-19 结局更严重,且易受影响。