End-stage Kidney Disease and COVID-19 in an Urban Safety-net Hospital in Boston, Massachusetts

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2021 Jun 4

PMID 34086775

Citations 3

Authors

Mohamed Hassan Kamel

Hassan Mahmoud

Aileen Zhen

Jing Liu

Catherine G Bielick

Anahita Mostaghim

Nina Lin

Vipul Chitalia

Titilayo Ilori

Sushrut S Waikar

Ashish Upadhyay

Affiliations

Soon will be listed here.

Abstract

Introduction: End-stage kidney disease (ESKD) patients are at a high risk for Coronavirus Disease 2019 (COVID-19). In this study, we compared characteristics and outcomes of ESKD and non-ESKD patients admitted with COVID-19 to a large safety-net hospital.

Methods: We evaluated 759 adults (45 with ESKD) hospitalized with COVID-19 in Spring of 2020. We examined clinical characteristics, laboratory measures and clinical outcomes. Logistic regression analyses were performed to investigate the associations between ESKD status and outcomes.

Results: 73% of ESKD and 47% of non-ESKD patients identified as Black (p = 0.002). ESKD patients were older and had higher rates of comorbidities. Admission ferritin was approximately 6-fold higher in ESKD patients. During hospitalization, the rise in white blood cell count, lactate dehydrogenase, ferritin and C-reactive protein, and the decrease in platelet count and serum albumin were all significantly greater in ESKD patients. The in-hospital mortality was higher for ESKD [18% vs. 10%; multivariable adjusted odds ratio 1.5 (95% CI, 0.48-4.70)], but this did not reach statistical significance.

Conclusions: Among hospitalized COVID-19 patients, ESKD patients had more co-morbidities and more robust inflammatory response than non-ESKD patients. The odds ratio point estimate for death was higher in ESKD patients, but the difference did not reach statistical significance.

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