COVID-19 in haemodialysis patients: result analysis of the first year of the pandemic
| Title: | COVID-19 in haemodialysis patients: result analysis of the first year of the pandemic |
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| Authors: | Mikhail L. Zubkin, Nadiya F. Frolova, Irina G. Kim, Anzhela I. Ushakova, Sergei S. Usatiuk, Rustam T. Iskhakov, Ekaterina N. Diakova, Valeriy I. Chervinko, Elizaveta V. Volodina, Natalia A. Tomilina, Evgeniy V. Kryukov |
| Source: | Терапевтический архив, Vol 93, Iss 11, Pp 1325-1333 (2021) |
| Publisher Information: | "Consilium Medicum" Publishing house, 2021. |
| Publication Year: | 2021 |
| Collection: | LCC:Medicine |
| Subject Terms: | chronic kidney disease, haemodialysis, covid-19, immunomodulators, Medicine |
| More Details: | Background. Present concepts of the novel coronavirus infection prognosis in haemodialysis (HD) patients are rather controversial. There is little information on therapy efficiency and safety in such patients. We studied COVID-19 course specifics, prognostic factors associated with fatal outcomes, therapy efficiency and its transformation at different stages of the pandemic first year. Materials and methods. Single-centre retrospective uncontrolled study included 653 COVID-19 HD-patients treated at Moscow City Nephrology Centre from April 1 to December 31, 2020. Results. This period mortality rate was 21.0%. Independent predictors of COVID-19 unfavourable outcome in HD patients were pulmonary lesion extension (CT grades 34), high comorbidity index, and mechanical ventilation. Approaches to COVID-19 treatment modified significantly at different periods. Immunomodulatory drugs (monoclonal antibodies to IL-6, corticosteroids) were used largely at later stages. With tocilizumab administration, mortality was 15.1%, tocilizumab together with dexamethasone 13.3%; without them 37.8% (р0,001). Tocilizumab administration in the first 3 days after hospitalization of patients with CT grades 12 was associated with more favourable outcomes: 1 out of 29 died vs 6 out of 20 (tocilizumab administered at later periods); p0.04. There was no significant difference in death frequency in patients with CT grades 34 depending on tocilizumab administration time. Conclusion. COVID-19 in HD patients can manifest in a severe course with unfavourable outcome. It is urgent to identify reliable disease outcome predictors and develop efficient treatment in this population. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | Russian |
| ISSN: | 0040-3660 2309-5342 00403660 |
| Relation: | https://ter-arkhiv.ru/0040-3660/article/viewFile/99604/73066; https://doaj.org/toc/0040-3660; https://doaj.org/toc/2309-5342 |
| DOI: | 10.26442/00403660.2021.11.201215 |
| Access URL: | https://doaj.org/article/6e50e0e6a478494ea763deb6961796d9 |
| Accession Number: | edsdoj.6e50e0e6a478494ea763deb6961796d9 |
| Database: | Directory of Open Access Journals |
| ISSN: | 00403660 23095342 |
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| DOI: | 10.26442/00403660.2021.11.201215 |
| Published in: | Терапевтический архив |
| Language: | Russian |