Clinical Profiles in Renal Patients with COVID-19

Arenas, María Dolores; Crespo, Marta; Pérez‐Sáez, María José; Collado, Sílvia; Redondo-Pachón, Dolores; Llinàs‐Mallol, Laura; Montero, María Milagro; Villar-García, Judith; Arias-Cabrales, Carlos; Barbosa, Francesc; Buxeda, Anna; Burballa, Carla; Sans, Laia; Vázquez, Susana; Oliveras, Anna; Mir, Marisa; Outón, Sara; Galceran, Isabel; Solá, Eulalia; Sierra, Adriana; Barrios, Clara; Rodríguez, Eva; Cao, Higini; Güerri‐Fernández, Robert; Horcajada, Juan Pablo; Pascual, Julio

doi:10.3390/jcm9082665

Cited by 16 publications

(15 citation statements)

References 48 publications

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“…The prevalence of confirmed COVID-19 in our cohort was 6.1%, lower than that described in other studies (range between 10–40%) [ 7 , 8 , 9 ]. There is a heterogeneous prevalence and mortality rate, according to different geographic areas, including within Spain [ 21 ].…”

Section: Discussioncontrasting

confidence: 83%

“…ARDS is, in part, the result of the storm of cytokines and chemo-attractant molecules that follow viral infection [ 6 ], which is aggravated by age and pre-existing conditions, including hypertension and diabetes [ 7 ]. Despite the prevalence of variable clinical presentation and outcomes in COVID-19 infected HD patients [ 8 , 9 , 10 ], the main factors driving the severity of disease progression in these specific patients remain to be elucidated.…”

Section: Introductionmentioning

confidence: 99%

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Mortality in Hemodialysis Patients with COVID-19, the Effect of Paricalcitol or Calcimimetics

et al. 2021

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Background. In COVID-19 patients, low serum vitamin D (VD) levels have been associated with severe acute respiratory failure and poor prognosis. In regular hemodialysis (HD) patients, there is VD deficiency and markedly reduced calcitriol levels, which may predispose them to worse outcomes of COVID-19 infection. Some hemodialysis patients receive treatment with drugs for secondary hyperparathyroidism, which have well known pleiotropic effects beyond mineral metabolism. The aim of this study was to evaluate the impact of VD status and the administration of active vitamin D medications, used to treat secondary hyperparathyroidism, on survival in a cohort of COVID-19 positive HD patients. Methods. A cross-sectional retrospective observational study was conducted from 12 March to 21 May 2020 in 288 HD patients with positive PCR for SARS-CoV2. Patients were from 52 different centers in Spain. Results. The percent of HD patients with COVID-19 was 6.1% (288 out of 4743). Mortality rate was 28.4% (81/285). Three patients were lost to follow-up. Serum 25(OH)D (calcidiol) level was 17.1 [10.6–27.5] ng/mL and was not significantly associated to mortality (OR 0.99 (0.97–1.01), p = 0.4). Patients receiving active vitamin D medications (16/94 (17%) vs. 65/191(34%), p = 0.003), including calcimimetics (4/49 (8.2%) vs. 77/236 (32.6%), p = 0.001), paricalcitol or calcimimetics (19/117 (16.2%) vs. 62/168 (36.9%); p < 0.001), and also those on both paricalcitol and calcimimetics, to treat secondary hyperparathyroidism (SHPTH) (1/26 (3.8%) vs. 80/259 (30.9%), p < 0.001) showed a lower mortality rate than patients receiving no treatment with either drug. Multivariate Cox regression analysis confirmed this increased survival. Conclusions. Our findings suggest that the use of paricalcitol, calcimimetics or the combination of both, seem to be associated with the improvement of survival in HD patients with COVID-19. No correlation was found between serum VD levels and prognosis or outcomes in HD patients with COVID-19. Prospective studies and clinical trials are needed to support these findings.

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Section: Discussioncontrasting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Mortality in Hemodialysis Patients with COVID-19, the Effect of Paricalcitol or Calcimimetics

et al. 2021

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“…Patients with kidney disease, both those requiring maintenance hemodialysis and transplant recipients, are at high risk for COVID-19 and a poor outcome. Preventive measures, thus, are crucial [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of a Nosocomial COVID-19 Outbreak on a Non-COVID-19 Nephrology Ward during the First Wave of the Pandemic in Spain

et al. 2021

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Introduction: The aim of this study was to analyze a nosocomial coronavirus disease 2019 (COVID-19) outbreak that occurred on a polyvalent non-COVID-19 ward at a tertiary care university hospital in Spain during the first wave of the pandemic and to describe the containment measures taken. The outbreak affected healthcare workers (HCWs) and kidney disease patients including transplant patients and those requiring maintenance hemodialysis. Methods: The outbreak investigation and report were conducted in accordance with the Orion statement guidelines. Results: In this study, 15 cases of COVID-19 affecting 10 patients and 5 HCWs were identified on a ward with 31 beds and 43 HCWs. The patients had tested negative for severe acute respiratory syndrome coronavirus 2 infection on admission. One of the HCWs was identified as the probable index case. Five patients died (mortality rate, 50%). They were all elderly and had significant comorbidities. The infection control measures taken included the transfer of infected patients to COVID-19 isolation wards, implementation of universal preventive measures, weekly PCR testing of patients and HCWs linked to the ward, training of HCWs on infection control and prevention measures, and enhancement of cleaning and disinfection. The outbreak was contained in 2 weeks, and no new cases occurred. Conclusion: Nosocomial COVID-19 outbreaks can have high attack rates involving both patients and HCWs and carry a high risk of patient mortality. Hospitals need to implement effective infection prevention and control strategies to prevent nosocomial COVID-19 spread.

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“…On the other hand, 7 patients had hypophosphatemia in our study and all were experiencing severe lung injury. Arenas et al (7) study showed hypophosphatemia in renal patients with confirmed COVID-19 in comparison of renal patients who were negative for the COVID-19 PCR test. Our study is in contrast with Arenas et al as we observed a wide range of serum phosphate levels in our patients with a reasonable association with HRCT results.…”

Section: Discussionmentioning

confidence: 96%

Phosphate levels and pulmonary damage in COVID-19 patients based on CO-RADS scheme: is there any link between parathyroid gland and COVID-19?

Javdani

Parsa

Shakeri

et al. 2020

Preprint

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Background: Preliminary studies of COVID-19 have provided some evidence that electrolyte disturbances may also be present in patients. In this study we aimed to evaluate the role of the arrival electrolytes and symptoms in prediction of Lung damage in CT scan based on the CO-RADS system. Methods: This was a retrospective cross-sectional analytical study. We included patients with laboratory confirmed COVID-19 infection, June 15 to July 7. Patients were included in study if there were no previous history of kidney disease. Demographic, clinical characteristics, laboratory findings, and CO-RADS High-resolution computed tomography (HRCT) of lung report were collected. Univariate logistic regression was employed first to identify the effective, correlated items. All statistics were performed with SPSS version 18.0. Results: In the current study, 36 (20 male- 16 female) patients with mean age of the 54.7 (STD:17.5) years old were studied. Most common symptom at the arrival was the Fever (52.8%), followed by Fatigue (18%), and dyspnea (44.4%). Computed tomography assessment revealed CO-RADS 2 in 4 (11.1%) patients, CO-RADS 3 in 1 (2.8%), CO-RADS 4 in 20 (55.6%), and CO-RADS 5 in 11 (30.6%) patients. In the comparison with the study groups based on the HRCT status (CO-RADS II,III vs. CO-RADS IV,V), patients with severe HRCT damage had significantly lower level of Phosphorus (P<0.05). Univariate logistic regression analysis showed that only one factors was associated with HRCT damage status (Phosphorus, P=0.040). Phosphorus upper than 4.5 was associated with better HRCT results with OR ratio of 3.71 (X2(1)=5.69; p=0.017). Conclusion: Our study illustrates that higher phosphate levels may be associated with better CT scan of lung outcomes in COVID-19; while hypophosphatemia is associated with severe lung injuries. This could help clinicians to manage hospitalized patients and may link the COVID-19 and parathyroid gland.

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Clinical Profiles in Renal Patients with COVID-19

Cited by 16 publications

References 48 publications

Mortality in Hemodialysis Patients with COVID-19, the Effect of Paricalcitol or Calcimimetics

Mortality in Hemodialysis Patients with COVID-19, the Effect of Paricalcitol or Calcimimetics

Impact of a Nosocomial COVID-19 Outbreak on a Non-COVID-19 Nephrology Ward during the First Wave of the Pandemic in Spain

Phosphate levels and pulmonary damage in COVID-19 patients based on CO-RADS scheme: is there any link between parathyroid gland and COVID-19?

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