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10.1681/ASN.2020040470

http://scihub22266oqcxt.onion/10.1681/ASN.2020040470
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32467113!7350989!32467113
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suck abstract from ncbi


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pmid32467113      J+Am+Soc+Nephrol 2020 ; 31 (7): 1409-1415
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  • Presentation and Outcomes of Patients with ESKD and COVID-19 #MMPMID32467113
  • Valeri AM; Robbins-Juarez SY; Stevens JS; Ahn W; Rao MK; Radhakrishnan J; Gharavi AG; Mohan S; Husain SA
  • J Am Soc Nephrol 2020[Jul]; 31 (7): 1409-1415 PMID32467113show ga
  • BACKGROUND: The relative immunosuppression and high prevalence of comorbidities in patients with ESKD on dialysis raise concerns that they may have an elevated risk of severe coronavirus disease 2019 (COVID-19), but outcomes for COVID-19 in such patients are unclear. METHODS: To examine presentation and outcomes of COVID-19 in patients with ESKD on dialysis, we retrospectively collected clinical data on 59 patients on dialysis who were hospitalized with COVID-19. We used Wilcoxon rank sum and Fischer exact tests to compare patients who died versus those still living. RESULTS: Two of the study's 59 patients were on peritoneal dialysis, and 57 were on hemodialysis. Median age was 63 years, with high prevalence of hypertension (98%) and diabetes (69%). Patients who died were significantly older than those still living (median age, 75 versus 62 years) and had a higher median Charlson comorbidity index (8 versus 7). The most common presenting symptoms were fever (49%) and cough (39%); initial radiographs most commonly showed multifocal or bilateral opacities (59%). By end of follow-up, 18 patients (31%) died a median 6 days after hospitalization, including 75% of patients who required mechanical ventilation. Eleven of those who died had advanced directives against intubation. The remaining 41 patients (69%) were discharged home a median 8 days after admission. The median initial white blood cell count was significantly higher in patients who died compared with those still living (7.5 versus 5.7x10(3)/mul), as was C-reactive protein (163 versus 80 mg/L). CONCLUSIONS: The association of COVID-19 with high mortality in patients with ESKD on dialysis reinforces the need to take appropriate infection control measures to prevent COVID-19 spread in this vulnerable population.
  • |*Outcome Assessment, Health Care[MESH]
  • |Adult[MESH]
  • |Age Factors[MESH]
  • |Aged[MESH]
  • |COVID-19[MESH]
  • |Cause of Death[MESH]
  • |Cohort Studies[MESH]
  • |Comorbidity[MESH]
  • |Coronavirus Infections/diagnosis/*epidemiology/therapy[MESH]
  • |Female[MESH]
  • |Hospital Mortality/trends[MESH]
  • |Hospitalization/statistics & numerical data[MESH]
  • |Hospitals, University[MESH]
  • |Humans[MESH]
  • |Infection Control/*organization & administration[MESH]
  • |Intensive Care Units/organization & administration[MESH]
  • |Kidney Failure, Chronic/diagnosis/*epidemiology/therapy[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |New York City[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/diagnosis/*epidemiology/therapy[MESH]
  • |Prevalence[MESH]
  • |Renal Dialysis/*methods/mortality[MESH]
  • |Retrospective Studies[MESH]
  • |Risk Assessment[MESH]
  • |Severity of Illness Index[MESH]
  • |Sex Factors[MESH]
  • |Statistics, Nonparametric[MESH]
  • |Survival Analysis[MESH]


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