Table 1.
Characteristics at first hemodialysis session following COVID-19 diagnosis
| Characteristic | All patients | Outpatient | Admitted | P value | Survived | Death | P value |
|---|---|---|---|---|---|---|---|
| Number of patients, n | 106 | 56 | 50 | 90 | 16 | ||
| Age | 65 (54–74) | 62 (52–72) | 68 (58–77) | 0.06 | 65 (53–72) | 76 (61–80) | 0.008a |
| Female | 40 (38) | 20 (36) | 20 (40) | 0.7 | 31 (34) | 9 (56) | 0.2 |
| BAME | 89 (84) | 45 (80) | 44 (88) | 0.3 | 73 (81) | 16 (100) | 0.07 |
| Active on transplant list | 24 (23) | 19 (34) | 7 (14) | 0.02b | 24 (27) | 2 (13) | 0.3 |
| Uses institutional transport | 40 (38) | 14 (25) | 26 (52) | 0.005c | 35 (39) | 5 (31) | 0.8 |
| Diabetes | 57 (54) | 30 (54) | 27 (54) | >0.99 | 48 (53) | 9 (56) | >0.99 |
| Prescribed ACEi or ARB | 37 (35) | 22 (39) | 15 (30) | 0.4 | 35 (39) | 2 (13) | 0.05d |
| Prescribed immunosuppression | 14 (13) | 7 (13) | 7 (14) | >0.99 | 13 (14) | 1 (6) | 0.7 |
| Cause ESKD | |||||||
| Genetic | 9 (8) | 8 (14) | 1 (2) | 0.2 | 9 (10) | 0 (0) | 0.3 |
| Autoimmune | 16 (15) | 13 (23) | 3 (6) | 0.02e | 16 (18) | 0 (0) | 0.1 |
| Diabetes | 45 (42) | 18 (32) | 27 (54) | 0.03f | 34 (38) | 11 (69) | 0.01g |
| Other vascular disease | 20 (19) | 10 (18) | 11 (22) | 0.6 | 17 (19) | 4 (25) | 0.5 |
| Other | 15 (14) | 7 (13) | 8 (16) | 0.8 | 14 (16) | 1 (6) | 0.5 |
| Symptoms | |||||||
| Fever (> 37.8 °C) | 87 (82) | 45 (80) | 42 (84) | 0.8 | 72 (80) | 15 (94) | 0.3 |
| Cough | 49 (46) | 27 (48) | 22 (44) | 0.7 | 42 (47) | 7 (44) | >0.99 |
| Breathlessness | 31 (29) | 10 (18) | 21 (42) | 0.01h | 27 (30) | 4 (25) | 0.8 |
| Myalgia | 28 (26) | 17 (30) | 11 (22) | 0.4 | 24 (27) | 4 (25) | >0.99 |
| Diarrhea | 20 (19) | 14 (25) | 6 (12) | 0.1 | 20 (22) | 0 (0) | 0.04i |
| Coryza | 17 (16) | 8 (14) | 9 (18) | 0.8 | 16 (18) | 1 (6) | 0.5 |
| Nausea | 9 (11) | 7 (18) | 2 (5) | 0.09 | 8 (12) | 1 (8) | >0.99 |
| Clinical observations pre-HD | |||||||
| SaO2 | 98 (96–100) | 99 (97–100) | 98 (95–100) | 0.03j | 99 (97–100) | 98 (93–100) | 0.05k |
| SBP (mm Hg) | 150 (132–165) | 147 (130–164) | 153 (134–174) | 0.4 | 150 (131–164) | 153 (138–175) | 0.6 |
| DBP (mm Hg) | 76 (64–88) | 77 (65–88) | 73 (62–86) | 0.4 | 77 (65–88) | 69 (61–85) | 0.1 |
| Blood tests | |||||||
| HB, g/l (NR 114–150) | 109 (98–120) | 112 (96–122) | 107 (98–113) | 0.1 | 109 (97–120) | 108 (100–116) | 0.9 |
| WCC, x 109/l (NR 4.2–11.2) | 4.8 (3.9–6.7) | 4.3 (3.8–6.0) | 5.3 (4.0–8.0) | 0.02l | 4.6 (3.9–6.4) | 5.7 (4.9–9.7) | 0.02m |
| Lymphocytes, x 109/l (NR 1.1–3.6) | 1.0 (0.7–1.4) | 1.0 (0.7–1.5) | 0.9 (0.7–1.4) | 0.5 | 1.0 (0.7–1.4) | 0.9 (0.6–1.4) | 0.5 |
| PLT, x 109/l (NR 135–400) | 161 (130–228) | 166 (135–230) | 153 (130–227) | 0.6 | 160 (131–229) | 171 (110–227) | 0.8 |
| CRP, mg/l (NR <5) | 44 (13–117) | 29 (10–71) | 94 (26–164) | <0.001n | 39 (13–100) | 142 (37–205) | 0.001o |
| ALT, unit/l (NR <34) | 14 (10–20) | 14 (9–19) | 14 (10–25) | 0.5 | 14 (10–21) | 14 (8–16) | 0.4 |
| LDH, unit/l (NR 125–243) | 285 (226–375) | 251 (221–341) | 324 (247–425) | 0.008p | 269 (226–367) | 341 (290–467) | 0.02q |
| Ferritin, μg/l (NR 20–300) | 799 (502–1276) | 723 (434–1041) | 893 (589–2012) | 0.02r | 786 (494–1276) | 864 (588–1893) | 0.4 |
| CK, unit/l (NR 25–200) | 88 (61–184) | 88 (63–167) | 85 (57–226) | 0.6 | 83 (62–168) | 132 (52–334) | 0.4 |
| Troponin, ng/l (NR <15) | 35 (22–92) | 29 (19–70) | 55 (29–137) | 0.02s | 33 (20–81) | 63 (39–207) | 0.006t |
| D-dimer, μg/l (NR <500) | 1499 (942–2751) | 1171 (674–2044) | 2096 (1280–3520) | <0.001u | 1468 (799–2615) | 2166 (1209–3533) | 0.1 |
ACEi, angiotensin-converting enzyme inhibitor; ALT, alanine aminotransferase; ARB, angiotensin 2 receptor blocker; BAME, Black, Asian and Minority Ethnic groups; CK, creatinine kinase; COVID-19, coronavirus disease 2019; CRP, C-reactive protein; DBP, diastolic blood pressure; ESKD, end-stage kidney disease; HB, hemoglobin; HD, hemodialysis; LDH, lactate dehydrogenase; Lymphocytes, lymphocyte count; NR, normal range; PLT, platelet count; SaO2, oxygen saturations measured by peripheral pulse oximetry; SBP, systolic blood pressure; WCC, white cell count.
The Outpatient cohort did not require admission to hospital during the course of COVID-19 disease and recovery. The Admitted cohort received inpatient care and hemodialysis at any point during COVID-19 disease. Data are reported as n (%) for categorical variables and median (interquartile range) for continuous variables. Differences are calculated with Fisher’s exact test for categorical and Mann-Whitney test for continuous variables.
Difference between medians 11.5 years (95% confidence interval [CI] 3–17 years).
Odds ratio (OR) for admission for active transplant waiting list status = 0.3 (95% CI 0.13–0.85).
OR for admission for using hospital-provided transport = 3.3 (95% CI 1.41–7.57).
OR for death for patients prescribed ACEi or ARB = 0.2 (95% CI 0.05–0.96).
OR for admission for patients with autoimmune causes of ESKD = 0.2 (95% CI 0.06–0.73).
OR for admission for patients with diabetes as cause of ESKD = 2.5 (95% CI 1.13–5.29).
OR for death for patients with diabetes as cause of ESKD = 4.3 (95% CI 1.46–11.6).
OR for admission for breathlessness at first dialysis post severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis = 3.3 (95% CI 1.41–8.33).
OR for death for diarrhea at first dialysis post SARS-CoV2 diagnosis = 0.1 (95% CI: 0.001–0.75).
Difference between medians 1% SaO2 (95% CI: 0.01–2).
Difference between medians 1% SaO2 (95% CI: 0.01–3).
Difference between medians 1.0 × 109/l (95% CI: 0.2–1.7).
Difference between medians 1.1 × 109/l (95% CI: 0.3–2.9).
Difference between medians 65 mg/l (95% CI: 15–79).
Difference between medians 103 mg/l (95% CI: 20–121).
Difference between medians 73 unit/l (95% CI: 13–93).
Difference between medians 72 unit/l (95% CI: 12–122).
Difference between medians 170 μg/l (95% CI: 36–474).
Difference between medians 26 ng/l (95% CI: 3–33).
Difference between medians 30 ng/l (95% CI: 9–93).
Difference between medians 925 μg/l (95% CI: 345–1351).