SARS-CoV-2 infection in chronic kidney disease patients with pre-existing dialysis: description across different pandemic intervals and effect on disease course (mortality)

the LEOSS Study Group

doi:10.1007/s15010-022-01826-7

SARS-CoV-2 infection in chronic kidney disease patients with pre-existing dialysis: description across different pandemic intervals and effect on disease course (mortality)

the LEOSS Study Group

Clinic of Infectious Diseases and Microbiology

1 Citation (Scopus)

Abstract

Purpose: Patients suffering from chronic kidney disease (CKD) are in general at high risk for severe coronavirus disease (COVID-19) but dialysis-dependency (CKD5D) is poorly understood. We aimed to describe CKD5D patients in the different intervals of the pandemic and to evaluate pre-existing dialysis dependency as a potential risk factor for mortality. Methods: In this multicentre cohort study, data from German study sites of the Lean European Open Survey on SARS-CoV-2-infected patients (LEOSS) were used. We multiply imputed missing data, performed subsequent analyses in each of the imputed data sets and pooled the results. Cases (CKD5D) and controls (CKD not requiring dialysis) were matched 1:1 by propensity-scoring. Effects on fatal outcome were calculated by multivariable logistic regression. Results: The cohort consisted of 207 patients suffering from CKD5D and 964 potential controls. Multivariable regression of the whole cohort identified age (> 85 years adjusted odds ratio (aOR) 7.34, 95% CI 2.45–21.99), chronic heart failure (aOR 1.67, 95% CI 1.25–2.23), coronary artery disease (aOR 1.41, 95% CI 1.05–1.89) and active oncological disease (aOR 1.73, 95% CI 1.07–2.80) as risk factors for fatal outcome. Dialysis-dependency was not associated with a fatal outcome—neither in this analysis (aOR 1.08, 95% CI 0.75–1.54) nor in the conditional multivariable regression after matching (aOR 1.34, 95% CI 0.70–2.59). Conclusions: In the present multicentre German cohort, dialysis dependency is not linked to fatal outcome in SARS-CoV-2-infected CKD patients. However, the mortality rate of 26% demonstrates that CKD patients are an extreme vulnerable population, irrespective of pre-existing dialysis-dependency.

Original language	English
Journal	Infection
Volume	51
Issue number	1
Pages (from-to)	71-81
Number of pages	11
ISSN	0300-8126
DOIs	https://doi.org/10.1007/s15010-022-01826-7
Publication status	Published - 02.2023

Funding

Open Access funding enabled and organized by Projekt DEAL. We acknowledge support by the Open Access Publication Fund of the University of Duisburg-Essen. LEOSS has received funding from the Willy Robert Pitzer Foundation and the German Center for Infection Research (DZIF). Felix C. Koehler reports grants by Else Kröner-Fresenius-Stiftung, by the German Research Foundation under Germany’s Excellence Strategy—EXC 2030: CECAD—Excellent in Aging Research—Project number 390661388, by the Maria-Pesch Stiftung, Cologne and by the Koeln Fortune program/Faculty of Medicine, University of Cologne outside of this project. All authors declare no relevant conflicts of interest. We express our deep gratitude to all study teams supporting the LEOSS study. The LEOSS study group contributed at least 5 per mille to the analyses of this study: Hospital Passau (Julia Lanznaster), University Hospital Duesseldorf (Bjoern-Erik Jensen), Klinikum Dortmund gGmbH, Hospital of University Witten/Herdecke (Martin Hower), Nephrological Center Villingen-Schwenningen (Bernd Hohenstein), Marien Hospital Herne Ruhr University Bochum (Timm Westhoff), University Hospital Frankfurt (Maria Vehreschild), Technical University of Munich (Christoph Spinner), University Hospital Jena (Maria Madeleine Ruethrich), Hospital Ernst von Bergmann (Lukas Tometten), Hospital Ingolstadt (Stefan Borgmann), University Hospital Cologne (Norma Jung), Hospital Bremen-Center (Bernd Hertenstein), Municipal Hospital Karlsruhe (Christian Degenhardt), Elisabeth Hospital Essen (Ingo Voigt), University Hospital Regensburg (Frank Hanses), Johannes Wesling Hospital Minden Ruhr University Bochum (Kai Wille), Hospital Maria Hilf GmbH Moenchengladbach (Juergen vom Dahl), Robert-Bosch-Hospital Stuttgart (Katja Rothfuss), Catholic Hospital Bochum (St. Josef Hospital) Ruhr University Bochum (Kerstin Hellwig), University Hospital Schleswig-Holstein Luebeck (Jan Rupp), University Hospital Wuerzburg (Nora Isberner), Hospital Leverkusen (Lukas Eberwein), University Hospital Bonn (Jacob Nattermann), University Hospital Erlangen (Richard Strauss), University Hospital Essen (Sebastian Dolff), University Hospital Tuebingen (Siri Göpel). The LEOSS study infrastructure group: Jörg Janne Vehreschild (Goethe University Frankfurt), Susana M. Nunes de Miranda (University Hospital of Cologne), Carolin E. M. Jakob (University Hospital of Cologne), Melanie Stecher (University Hospital of Cologne), Lisa Pilgram (Goethe University Frankfurt), Nick Schulze (University Hospital of Cologne), Sandra Fuhrmann (University Hospital of Cologne), Max Schons (University Hospital of Cologne), Annika Claßen (University Hospital of Cologne), Bernd Franke (University Hospital of Cologne) und Fabian Prasser (Berlin Institute of Health @ Charité—Universitätsmedizin Berlin).

Coronavirus related work

Research on SARS-CoV-2 / COVID-19

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1007/s15010-022-01826-7

Cite this

@article{d8017e87840d417a99c1c9d9b73748c3,

title = "SARS-CoV-2 infection in chronic kidney disease patients with pre-existing dialysis: description across different pandemic intervals and effect on disease course (mortality)",

abstract = "Purpose: Patients suffering from chronic kidney disease (CKD) are in general at high risk for severe coronavirus disease (COVID-19) but dialysis-dependency (CKD5D) is poorly understood. We aimed to describe CKD5D patients in the different intervals of the pandemic and to evaluate pre-existing dialysis dependency as a potential risk factor for mortality. Methods: In this multicentre cohort study, data from German study sites of the Lean European Open Survey on SARS-CoV-2-infected patients (LEOSS) were used. We multiply imputed missing data, performed subsequent analyses in each of the imputed data sets and pooled the results. Cases (CKD5D) and controls (CKD not requiring dialysis) were matched 1:1 by propensity-scoring. Effects on fatal outcome were calculated by multivariable logistic regression. Results: The cohort consisted of 207 patients suffering from CKD5D and 964 potential controls. Multivariable regression of the whole cohort identified age (> 85 years adjusted odds ratio (aOR) 7.34, 95\% CI 2.45–21.99), chronic heart failure (aOR 1.67, 95\% CI 1.25–2.23), coronary artery disease (aOR 1.41, 95\% CI 1.05–1.89) and active oncological disease (aOR 1.73, 95\% CI 1.07–2.80) as risk factors for fatal outcome. Dialysis-dependency was not associated with a fatal outcome—neither in this analysis (aOR 1.08, 95\% CI 0.75–1.54) nor in the conditional multivariable regression after matching (aOR 1.34, 95\% CI 0.70–2.59). Conclusions: In the present multicentre German cohort, dialysis dependency is not linked to fatal outcome in SARS-CoV-2-infected CKD patients. However, the mortality rate of 26\% demonstrates that CKD patients are an extreme vulnerable population, irrespective of pre-existing dialysis-dependency.",

author = "\{the LEOSS Study Group\} and Lisa Pilgram and Lukas Eberwein and Jensen, \{Bjoern Erik O.\} and Jakob, \{Carolin E.M.\} and Koehler, \{Felix C.\} and Martin Hower and Kielstein, \{Jan T.\} and Melanie Stecher and Bernd Hohenstein and Fabian Prasser and Timm Westhoff and \{de Miranda\}, \{Susana M.Nunes\} and Maria Vehreschild and Julia Lanznaster and Sebastian Dolff and Jensen, \{Bjoern Erik\} and Maria Vehreschild and Christoph Spinner and Ruethrich, \{Maria Madeleine\} and Lukas Tometten and Stefan Borgmann and Norma Jung and Bernd Hertenstein and Christian Degenhardt and Ingo Voigt and Frank Hanses and Kai Wille and Dahl, \{Juergen vom\} and Katja Rothfuss and Kerstin Hellwig and Jan Rupp and Nora Isberner and Jacob Nattermann and Richard Strauss and Sebastian Dolff and Siri G{\"o}pel and Vehreschild, \{J{\"o}rg Janne\} and Nick Schulze and Sandra Fuhrmann and Max Schons and Annika Cla{\ss}en and Bernd Franke",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2023",

month = feb,

doi = "10.1007/s15010-022-01826-7",

language = "English",

volume = "51",

pages = "71--81",

journal = "Infection",

issn = "0300-8126",

publisher = "Springer Science and Business Media Deutschland GmbH",

number = "1",

}

TY - JOUR

T1 - SARS-CoV-2 infection in chronic kidney disease patients with pre-existing dialysis

T2 - description across different pandemic intervals and effect on disease course (mortality)

AU - the LEOSS Study Group

AU - Pilgram, Lisa

AU - Eberwein, Lukas

AU - Jensen, Bjoern Erik O.

AU - Jakob, Carolin E.M.

AU - Koehler, Felix C.

AU - Hower, Martin

AU - Kielstein, Jan T.

AU - Stecher, Melanie

AU - Hohenstein, Bernd

AU - Prasser, Fabian

AU - Westhoff, Timm

AU - de Miranda, Susana M.Nunes

AU - Vehreschild, Maria

AU - Lanznaster, Julia

AU - Dolff, Sebastian

AU - Jensen, Bjoern Erik

AU - Vehreschild, Maria

AU - Spinner, Christoph

AU - Ruethrich, Maria Madeleine

AU - Tometten, Lukas

AU - Borgmann, Stefan

AU - Jung, Norma

AU - Hertenstein, Bernd

AU - Degenhardt, Christian

AU - Voigt, Ingo

AU - Hanses, Frank

AU - Wille, Kai

AU - Dahl, Juergen vom

AU - Rothfuss, Katja

AU - Hellwig, Kerstin

AU - Rupp, Jan

AU - Isberner, Nora

AU - Nattermann, Jacob

AU - Strauss, Richard

AU - Dolff, Sebastian

AU - Göpel, Siri

AU - Vehreschild, Jörg Janne

AU - Schulze, Nick

AU - Fuhrmann, Sandra

AU - Schons, Max

AU - Claßen, Annika

AU - Franke, Bernd

PY - 2023/2

Y1 - 2023/2

N2 - Purpose: Patients suffering from chronic kidney disease (CKD) are in general at high risk for severe coronavirus disease (COVID-19) but dialysis-dependency (CKD5D) is poorly understood. We aimed to describe CKD5D patients in the different intervals of the pandemic and to evaluate pre-existing dialysis dependency as a potential risk factor for mortality. Methods: In this multicentre cohort study, data from German study sites of the Lean European Open Survey on SARS-CoV-2-infected patients (LEOSS) were used. We multiply imputed missing data, performed subsequent analyses in each of the imputed data sets and pooled the results. Cases (CKD5D) and controls (CKD not requiring dialysis) were matched 1:1 by propensity-scoring. Effects on fatal outcome were calculated by multivariable logistic regression. Results: The cohort consisted of 207 patients suffering from CKD5D and 964 potential controls. Multivariable regression of the whole cohort identified age (> 85 years adjusted odds ratio (aOR) 7.34, 95% CI 2.45–21.99), chronic heart failure (aOR 1.67, 95% CI 1.25–2.23), coronary artery disease (aOR 1.41, 95% CI 1.05–1.89) and active oncological disease (aOR 1.73, 95% CI 1.07–2.80) as risk factors for fatal outcome. Dialysis-dependency was not associated with a fatal outcome—neither in this analysis (aOR 1.08, 95% CI 0.75–1.54) nor in the conditional multivariable regression after matching (aOR 1.34, 95% CI 0.70–2.59). Conclusions: In the present multicentre German cohort, dialysis dependency is not linked to fatal outcome in SARS-CoV-2-infected CKD patients. However, the mortality rate of 26% demonstrates that CKD patients are an extreme vulnerable population, irrespective of pre-existing dialysis-dependency.

AB - Purpose: Patients suffering from chronic kidney disease (CKD) are in general at high risk for severe coronavirus disease (COVID-19) but dialysis-dependency (CKD5D) is poorly understood. We aimed to describe CKD5D patients in the different intervals of the pandemic and to evaluate pre-existing dialysis dependency as a potential risk factor for mortality. Methods: In this multicentre cohort study, data from German study sites of the Lean European Open Survey on SARS-CoV-2-infected patients (LEOSS) were used. We multiply imputed missing data, performed subsequent analyses in each of the imputed data sets and pooled the results. Cases (CKD5D) and controls (CKD not requiring dialysis) were matched 1:1 by propensity-scoring. Effects on fatal outcome were calculated by multivariable logistic regression. Results: The cohort consisted of 207 patients suffering from CKD5D and 964 potential controls. Multivariable regression of the whole cohort identified age (> 85 years adjusted odds ratio (aOR) 7.34, 95% CI 2.45–21.99), chronic heart failure (aOR 1.67, 95% CI 1.25–2.23), coronary artery disease (aOR 1.41, 95% CI 1.05–1.89) and active oncological disease (aOR 1.73, 95% CI 1.07–2.80) as risk factors for fatal outcome. Dialysis-dependency was not associated with a fatal outcome—neither in this analysis (aOR 1.08, 95% CI 0.75–1.54) nor in the conditional multivariable regression after matching (aOR 1.34, 95% CI 0.70–2.59). Conclusions: In the present multicentre German cohort, dialysis dependency is not linked to fatal outcome in SARS-CoV-2-infected CKD patients. However, the mortality rate of 26% demonstrates that CKD patients are an extreme vulnerable population, irrespective of pre-existing dialysis-dependency.

UR - https://www.scopus.com/pages/publications/85136994264

UR - https://www.mendeley.com/catalogue/fa4720c9-1037-30d6-95e2-7b1e521caf3e/

U2 - 10.1007/s15010-022-01826-7

DO - 10.1007/s15010-022-01826-7

M3 - Journal articles

C2 - 35486356

AN - SCOPUS:85136994264

SN - 0300-8126

VL - 51

SP - 71

EP - 81

JO - Infection

JF - Infection

IS - 1

ER -

SARS-CoV-2 infection in chronic kidney disease patients with pre-existing dialysis: description across different pandemic intervals and effect on disease course (mortality)

Abstract

Funding

Coronavirus related work

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this