Zhongguo linchuang yanjiu (Jan 2024)
Risk factors associated with severe coronavirus disease 2019 in maintenance hemodialysis patients
Abstract
Objective: To analyze the risk factors of severe coronavirus disease 2019 (COVID-19) in maintenance hemodialysis patients, and provide reference for early risk identification of the patients. Method: The clinical data of 73 maintenance hemodialysis patients diagnosed with COVID-19 admitted to Jilin Province People's Hospital from March to April 2022 were restrospectinely collected, and the patients were divided into MC group (mild and ordinary type, n=61) and SC group (severe and critically severe type, n=12) based on clinical classification. The patients' baseline data ［age, gender, COVID-19 vaccination status, age adjusted Charlson's complication index (aCCI), primary hypertension, diabetes, coronary heart disease, malignant tumor, dialysis time］, first clinical symptoms (fever, dry cough, fatigue, sore throat, diarrhea, dyspnea) and laboratory examination indexes within 24 hours of admission (total number of white blood cells, neutrophils and lymphocytes; C-reactive protein, procalcitonin, D-dimer, albumin) were collected. Multivariate logistic regression analysis was used to identify the risk factors for severe COVID-19 in maintenance hemodialysis patients. Results: There were statistically significant differences in age, aCCI, total lymphocyte count, C-reactive protein and D-dimer between the two groups (P＜0.01). Multivariate logistic regression analysis showed that older age and higher C-reactive protein level were the independent risk factors for severe COVID-19 in maintenance hemodialysis patients (OR=1.256, 95%CI:1.016-1.553, P=0.035; OR=1.021, 95%CI: 1.001-1.041, P=0.041). Conclusion: The COVID-19 vaccination rate of maintenance hemodialysis patients is low, the overall age is older. Older age and higher level of C-reactive protein are independent risk factors for severe COVID-19 in maintenance hemodialysis patients.
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