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Lai S, Tinti F, Perrotta AM, Salomone L, Cianci R, Izzo P, Izzo S, Izzo L, De Intinis C, Pellicano C, Gigante A. COVID-19 Infection in Autosomal Dominant Polycystic Kidney Disease and Chronic Kidney Disease Patients: Progression of Kidney Disease. Biomedicines 2024; 12:1301. [PMID: 38927508 PMCID: PMC11201050 DOI: 10.3390/biomedicines12061301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION the COVID-19 pandemic has brought to light the intricate interplay between viral infections and preexisting health conditions. In the field of kidney diseases, patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) and Chronic Kidney Disease (CKD) face unique challenges when exposed to the SARS-CoV-2 virus. This study aims to evaluate whether SARS-CoV-2 virus infection impacts renal function differently in patients suffering from ADPKD and CKD when compared to patients suffering only from CKD. MATERIALS AND METHODS clinical data from 103 patients were collected and retrospectively analyzed. We compared the renal function of ADPKD and CKD patients at two distinct time points: before COVID-19 infection (T0) and 1 year after the infection (T1). We studied also a subpopulation of 37 patients with an estimated glomerular filtration rate (eGFR) < 60 mL/min and affected by ADPKD and CKD. RESULTS clinical data were obtained from 59 (57.3%) ADPKD patients and 44 (42.7%) CKD patients. At T1, ADPKD patients had significantly higher serum creatinine levels compared to CKD patients, and a significantly lower eGFR was observed only in ADPKD patients with eGFR < 60 mL/min compared to CKD patients (p < 0.01, p < 0.05; respectively). Following COVID-19 infection, ADPKD-CKD patients exhibited significantly higher variation in both median serum creatinine (p < 0.001) and median eGFR (p < 0.001) compared to CKD patients. CONCLUSION the interplay between COVID-19 and kidney disease is complex. In CKD patients, the relationship between COVID-19 and kidney disease progression is more established, while limited studies exist on the specific impact of COVID-19 on ADPKD patients. Current evidence does not suggest that ADPKD patients are at a higher risk of SARS-CoV-2 infection; however, in our study we showed a significant worsening of the renal function among ADPKD patients, particularly those with an eGFR < 60 mL/min, in comparison to patients with only CKD after a one-year follow-up from COVID-19 infection.
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Affiliation(s)
- Silvia Lai
- Department of Translational and Precision Medicine, UOC Nephrology, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (A.M.P.); (L.S.); (R.C.)
| | - Francesca Tinti
- Department of Translational and Precision Medicine, UOC Nephrology, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (A.M.P.); (L.S.); (R.C.)
| | - Adolfo Marco Perrotta
- Department of Translational and Precision Medicine, UOC Nephrology, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (A.M.P.); (L.S.); (R.C.)
| | - Luca Salomone
- Department of Translational and Precision Medicine, UOC Nephrology, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (A.M.P.); (L.S.); (R.C.)
| | - Rosario Cianci
- Department of Translational and Precision Medicine, UOC Nephrology, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (A.M.P.); (L.S.); (R.C.)
| | - Paolo Izzo
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy; (P.I.); (L.I.); (C.D.I.)
| | - Sara Izzo
- Plastic Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Luciano Izzo
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy; (P.I.); (L.I.); (C.D.I.)
| | - Claudia De Intinis
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy; (P.I.); (L.I.); (C.D.I.)
| | - Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (C.P.); (A.G.)
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (C.P.); (A.G.)
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Transplant: The Success of Renal Transplant Programs. Semin Nephrol 2023; 42:151312. [PMID: 36931206 DOI: 10.1016/j.semnephrol.2023.151312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
In the absence of malignancy or other severe comorbidity, kidney transplantation offers better survival rates and quality of life than dialysis. Despite this survival advantage, many lower- and upper-middle-income countries do not offer adequate kidney transplant services. This is particularly troubling because end-stage kidney disease often is more common in these countries than in high-income countries and overall is less costly in the life of a patient. We describe the contrasting levels of provision of kidney transplantation in Mexico, India, Nigeria, Ghana, and Zimbabwe, and kidney transplant services for children in Africa.
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Parra-Bracamonte G, Lopez-Villalobos N, Velazquez M, Parra-Bracamonte F, Perales-Torres A, Juárez Rendón K. Comparative analysis of risk factors for COVID-19 mortality before, during and after the vaccination programme in Mexico. Public Health 2023; 215:94-99. [PMID: 36652788 PMCID: PMC9767886 DOI: 10.1016/j.puhe.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/18/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The purpose of this study was to compare case fatality rates (CFRs) and odds for mortality by risk factors of patients with COVID-19 in Mexico, before, during and after the implementation of the national COVID-19 vaccination programme. STUDY DESIGN A large database including COVID-19 monitoring cases was used to perform an observational retrospective study. METHODS The Chi-squared test and multivariate logistic regression analyses were applied to data from COVID-19-positive patients in Mexico. Data were analysed over 3 years, 2020, 2021 and 2022, corresponding with pre-, during and post-vaccination periods. The unadjusted odds ratios and 95% confidence interval were used to estimate the risk factors for COVID-19 mortality in each of the years. RESULTS Statistically significant differences in CFR and odds ratio were found in the studied years, favouring postvaccination period. Significant changes in CFR by age, sex and main comorbidities indicated changes in the epidemic dynamics after the implementation of the COVID-19 vaccination campaign. The likelihood of death increased for hospitalised cases and for patients who were middle-aged or older in 2021 and 2022, whereas the odds of death associated with sex and comorbidities remained similar or reduced over the 3 years. CONCLUSIONS Implementation of the COVID-19 vaccination programme during 2021 showed positive consequences on CFR. The increased odds of dying in hospitalised patients are likely to be due to the unvaccinated proportion of patients.
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Affiliation(s)
- G.M. Parra-Bracamonte
- Centro de Biotecnología Genómica-Instituto Politécnico Nacional, Reynosa, 87710, Mexico,Corresponding author. Centro de Biotecnología Genómica-IPN, Blvd. del Maestro SN, Esq. Elías Piña, Col. Narciso Mendoza, Reynosa, C.P. 88710, Tamaulipas, Mexico. Tel.: +52 8999243627x87709
| | - N. Lopez-Villalobos
- School of Agriculture and Environment, Massey University, Palmerston North, 4442, New Zealand
| | - M.A. Velazquez
- School of Natural & Environmental Sciences, Newcastle University, Newcastle Upon Tyne, NE1 7RU, United Kingdom
| | | | - A.L. Perales-Torres
- Unidad Académica Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Reynosa, 88710, Mexico
| | - K.J. Juárez Rendón
- Centro de Biotecnología Genómica-Instituto Politécnico Nacional, Reynosa, 87710, Mexico
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Rana R, Ranjan V, Kumar N, Chugh P, Khillan K, Gogia A, Rana DS, Ganguly NK. Association of underlying comorbidities and progression of COVID-19 infection amongst 2586 patients hospitalised in the National Capital Region of India: a retrospective cohort study. Mol Cell Biochem 2023; 478:149-160. [PMID: 35750979 PMCID: PMC9244570 DOI: 10.1007/s11010-022-04485-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 05/20/2022] [Indexed: 01/17/2023]
Abstract
This study is conducted to observe the association of diabetes (DM), hypertension (HTN) and chronic kidney disease (CKD) on the prognosis and mortality of COVID-19 infection in hospital admitted patients with above mentioned comorbidities. This is a single centre, observational, retrospective study carried out at Sir Ganga Ram Hospital, Delhi, India. The burden of comorbidities on the prognosis and clinical outcome of COVID-19 patients admitted patients from April 8, 2020, to October 4, 2020. Chi-square and relative risk test were used to observe the association of comorbidities and disease prognosis. A total of 2586 patients were included in the study consisting of 69.6% of male patients. All the comorbidities were significantly associated with ICU admission and mortality. The relative risk showed that CKD is most prone to severity as well as mortality of the COVID-19 infection followed by HTN and DM. Further with the increase in number of underlying comorbidities, the risk of ICU admission and mortality also increases. Relative risk of the severity of COVID-19 infection in younger patients with underlying comorbidities are relatively at higher risk of severity of disease as well as to mortality compared to the elderly patients with similar underlying condition. Similarly, it is found that females are relatively at higher risk of mortality as compared to the males having same comorbid conditions except for the hypertensive patients. Diabetes, hypertension and CKD, all are associated with progression of COVID-19 disease to severity and higher mortality risk. The number of underlying comorbid condition is directly proportional to the progression of disease severity and mortality.
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Affiliation(s)
- Rashmi Rana
- Department of Research, Sir Ganga Ram Hospital, New Delhi, 110060 India
| | - Vivek Ranjan
- Department of Blood Transfusion Medicine, Sir Ganga Ram Hospital, New Delhi, 110060 India
| | - Naveen Kumar
- Department of Research, Sir Ganga Ram Hospital, New Delhi, 110060 India
| | - Parul Chugh
- Department of Research, Sir Ganga Ram Hospital, New Delhi, 110060 India
| | - Kamini Khillan
- Department of Blood Transfusion Medicine, Sir Ganga Ram Hospital, New Delhi, 110060 India
| | - Atul Gogia
- Department of Internal Medicine, Sir Ganga Ram Hospital, New Delhi, 110060 India
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Al Bastaki NA, Sheek-Hussein M, Shukla A, Al-Bluwi N, Saddik B. An Evaluation of Non-Communicable Diseases and Risk Factors Associated with COVID-19 Disease Severity in Dubai, United Arab Emirates: An Observational Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14381. [PMID: 36361255 PMCID: PMC9659060 DOI: 10.3390/ijerph192114381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to determine the prevalence of non-communicable diseases and their correlation with COVID-19 disease severity among patients infected in Dubai. Clinical and demographic data were extracted from hospital records of 34,687 COVID-19 patients who visited or were admitted into Dubai hospitals between 28 January 2020 and 30 September 2020. Prevalence of co-morbidities in COVID-19 patients were assessed. The main risk factors associated with COVID-19 disease severity were also identified using three regression models. All co-morbidities were significantly associated with COVID-19 severity in the bivariate analysis (p-value ≤ 0.05) except for vitamin-D deficiency and chronic lower respiratory diseases. Patients with ischemic heart diseases (AOR: 2.08; 95% CI: 1.37, 3.15), pulmonary and other heart diseases (AOR: 2.13; 95% CI: 1.36, 3.32) and chronic kidney diseases (AOR: 1.81; 95% CI: 1.01, 3.25) had higher odds of severe COVID-19 symptoms. Suffering from multiple co-morbidities increased the odds of developing severe COVID-19 symptoms substantially in comparison to having only one co-morbidity i.e., (AOR: 1.52; 95% CI 1.76-2.60) to (AOR: 2.33; 95% CI: 1.37, 3.97). Identifying these risk factors could assist in the early recognition of high-risk populations and ensure the most appropriate preventive measures and required medical management during the pandemic.
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Affiliation(s)
| | - Mohamud Sheek-Hussein
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain P.O. Box 15551, United Arab Emirates
- School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA
| | - Ankita Shukla
- Sharjah Institute for Medical and Health Sciences Research, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| | - Najlaa Al-Bluwi
- Sharjah Institute for Medical and Health Sciences Research, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| | - Basema Saddik
- Sharjah Institute for Medical and Health Sciences Research, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
- Department of Family and Community Medicine and Behavioural Sciences, College of Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
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Sitjar-Suñer M, Suñer-Soler R, Bertran-Noguer C, Masià-Plana A, Romero-Marull N, Reig-Garcia G, Alòs F, Patiño-Masó J. Mortality and Quality of Life with Chronic Kidney Disease: A Five-Year Cohort Study with a Sample Initially Receiving Peritoneal Dialysis. Healthcare (Basel) 2022; 10:healthcare10112144. [PMID: 36360484 PMCID: PMC9690964 DOI: 10.3390/healthcare10112144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/17/2022] [Accepted: 10/22/2022] [Indexed: 11/29/2022] Open
Abstract
The quality of life, morbidity and mortality of people receiving renal replacement therapy is affected both by the renal disease itself and its treatment. The therapy that best improves renal function and quality of life is transplantation. Objectives: To study the quality of life, morbidity and mortality of people receiving renal replacement therapy over a five-year period. Design: A longitudinal multicentre study of a cohort of people with chronic kidney disease. Methods: Patients from the Girona health area receiving peritoneal dialysis were studied, gathering data on sociodemographic and clinical variables through an ad hoc questionnaire, quality of life using the SF-36 questionnaire, and social support with the MOS scale. Results: Mortality was 47.2%. Physical functioning was the variable that worsened most in comparison with the first measurement (p = 0.035). Those receiving peritoneal dialysis (p = 0.068) and transplant recipients (p = 0.083) had a better general health perception. The social functioning of transplant recipients improved (p = 0.008). Conclusions: People with chronic kidney disease had a high level of mortality. The dimension of physical functioning worsens over the years. Haemodialysis is the therapy that most negatively effects general health perception. Kidney transplantation has a positive effect on the dimensions of energy/vitality, social functioning and general health perception.
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Affiliation(s)
- Miquel Sitjar-Suñer
- Primary Health Centre, Institut Català de la Salut, 17800 Olot, Spain
- Nursing Department, University of Girona, 17003 Girona, Spain
| | - Rosa Suñer-Soler
- Nursing Department, University of Girona, 17003 Girona, Spain
- Health and Health Care Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain
- Correspondence:
| | - Carme Bertran-Noguer
- Nursing Department, University of Girona, 17003 Girona, Spain
- Health and Health Care Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain
| | - Afra Masià-Plana
- Nursing Department, University of Girona, 17003 Girona, Spain
- Health and Health Care Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain
| | | | - Glòria Reig-Garcia
- Nursing Department, University of Girona, 17003 Girona, Spain
- Health and Health Care Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain
| | - Francesc Alòs
- Primary Health Centre, Passeig de Sant Joan, Institut Català de la Salut, 08010 Barcelona, Spain
| | - Josefina Patiño-Masó
- Nursing Department, University of Girona, 17003 Girona, Spain
- Quality of Life Research Institute, University of Girona, 17003 Girona, Spain
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Iryaningrum MR, Supriyadi R, Lawrensia S, Henrina J, Soetedjo NNM. Diabetes and Mortality among Patients with Chronic Kidney Disease and COVID-19: A Systematic Review, Meta-analysis, and Meta-regression. Indian J Nephrol 2022; 32:327-333. [PMID: 35967541 PMCID: PMC9364990 DOI: 10.4103/ijn.ijn_293_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/02/2021] [Accepted: 10/10/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction: Patients with kidney disease and COVID-19, whether on hemodialysis (HD) or not, have a higher risk of contracting COVID-19 accompanied by a higher mortality rate due to suppressed immune functions. Diabetes, one of the ubiquitous etiology of kidney disease, is also associated with a composite of poor outcomes. Methods: Meta-analysis and meta-regression of 13 articles on COVID-19 patients with chronic kidney disease, with information on diabetes and mortality were performed using Review Manager 5.4 and OpenMetaAnalyst. Results: The meta-analysis of a pooled subject of 18,822 patients showed that the presence of diabetes in CKD patients with COVID-19 was associated with an increased risk of mortality (RR 1.41 (1.15, 1.72); P < 0.001; I2 70%, P < 0.001). Subgroup analysis showed that diabetes was not associated with mortality in the HD group (RR 1.27 (1.06, 1.54); P = 0.01; I2 0%, P = 0.70) but showed a significant association in the non-HD group (RR 1.66 (1.59, 1.73); P < 0.001; I2 85%, P < 0.001). Male gender (P = 0.070) contributed to the effect size differences (age: P < 0.001; hypertension: P = 0.007; CVD: P < 0.001; lung disease: P < 0.001). Conclusions: Diabetes was associated with higher mortality risk among CKD patients, primarily those who did not need RRT.
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Affiliation(s)
- Maria R Iryaningrum
- Department of Internal Medicine, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Rudi Supriyadi
- Department of Internal Medicine, Division of Nephrology and Hypertension, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Sherly Lawrensia
- Department of Medicine, Regional Public Hospital of Waikabubak, Tangerang, Indonesia
| | - Joshua Henrina
- Department of Medicine, Balaraja Public Health Centre, Tangerang, Indonesia
| | - Nanny Natalia M Soetedjo
- Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran - Dr Hasan Sadikin Hospital, Bandung, Indonesia
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Puicón-Suárez JB, Zeña-Ñañez S, Failoc-Rojas VE. Association between chronic kidney disease and mortality in patients with a confirmed COVID-19 diagnosis. PeerJ 2022; 10:e13437. [PMID: 35722260 PMCID: PMC9205307 DOI: 10.7717/peerj.13437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/22/2022] [Indexed: 01/14/2023] Open
Abstract
Objective To determine the association between chronic kidney disease (CKD) and mortality in persons with a confirmed coronavirus disease 2019 (COVID-19) diagnosis. Methods Cross-sectional secondary baseline study. The study population consisted of 243,065 patients confirmed to have COVID-19 during May-December 2020. Stata 16.0 was used for statistical analysis, Chi-square test was used for bivariate analysis, and Poisson regression with robust variances was used for multiple analysis. Results The prevalence of patients with a confirmed COVID-19 diagnosis who had CKD and died was 1.42 times the prevalence of mortality in those without CKD. The comorbidities combined with CKD that presented the highest probability of mortality were diabetes mellitus and hypertension. Conclusions CKD is associated with a high mortality rate in patients with a confirmed COVID-19 diagnosis. Patients with CKD, diabetes mellitus, and arterial hypertension have a higher prevalence of mortality than those without comorbidities.
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Affiliation(s)
| | | | - Virgilio E. Failoc-Rojas
- Universidad San Ignacio de Loyola, Lima, Peru
- EsSalud, Instituto de Evaluación de Tecnologías en Salud e Investigación, Lima, Lima, Peru
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Perez-Moran D, Perez-Cuevas R, Doubova SV. Challenges for Peritoneal Dialysis Centers Before and During the COVID-19 Pandemic in Mexico. Arch Med Res 2022; 53:431-440. [PMID: 35527074 PMCID: PMC9050655 DOI: 10.1016/j.arcmed.2022.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/31/2022] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Diana Perez-Moran
- Unidad de Investigación en Epidemiología y Servicios de Salud Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Ricardo Perez-Cuevas
- Division of Social Protection and Health, Interamerican Development Bank, Jamaica Country Office, Jamaica
| | - Svetlana V Doubova
- Unidad de Investigación en Epidemiología y Servicios de Salud Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
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Jdiaa SS, Mansour R, El Alayli A, Gautam A, Thomas P, Mustafa RA. COVID-19 and chronic kidney disease: an updated overview of reviews. J Nephrol 2022; 35:69-85. [PMID: 35013985 PMCID: PMC8747880 DOI: 10.1007/s40620-021-01206-8] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/08/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Coronavirus disease (COVID-19) has resulted in the death of more than 3.5 million people worldwide. While COVID-19 mostly affects the lungs, different comorbidities can have an impact on its outcomes. We performed an overview of reviews to assess the effect of Chronic Kidney Disease (CKD) on contracting COVID-19, hospitalization, mortality, and disease severity. METHODS We searched published and preprint databases. We updated the reviews by searching for primary studies published after August 2020, and prioritized reviews that are most updated and of higher quality using the AMSTAR tool. RESULTS We included 69 systematic reviews and 66 primary studies. Twenty-eight reviews reported on the prevalence of CKD among patients with COVID-19, which ranged from 0.4 to 49.0%. One systematic review showed an increased risk of hospitalization in patients with CKD and COVID-19 (RR = 1.63, 95% CI 1.03-2.58) (Moderate certainty). Primary studies also showed a statistically significant increase of hospitalization in such patients. Thirty-seven systematic reviews assessed mortality risk in patients with CKD and COVID-19. The pooled estimates from primary studies for mortality in patients with CKD and COVID-19 showed a HR of 1.48 (95% CI 1.33-1.65) (Moderate certainty), an OR of 1.77 (95% CI 1.54-2.02) (Moderate certainty) and a RR of 1.6 (95% CI 0.88-2.92) (Low certainty). CONCLUSIONS Our review highlights the impact of CKD on the poor outcomes of COVID-19, underscoring the importance of identifying strategies to prevent COVID-19 infection among patients with CKD.
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Affiliation(s)
- Sara S Jdiaa
- Division of Nephrology, University of Toronto, Toronto, ON, Canada
| | - Razan Mansour
- Division of Nephrology and Hypertension, Department of Internal Medicine, Medical Center, University of Kansas, Kansas City, KS, USA
| | - Abdallah El Alayli
- Division of Nephrology and Hypertension, Department of Internal Medicine, Medical Center, University of Kansas, Kansas City, KS, USA
| | - Archana Gautam
- Division of Nephrology and Hypertension, Department of Internal Medicine, Medical Center, University of Kansas, Kansas City, KS, USA
| | - Preston Thomas
- School of Medicine, University of Kansas, Kansas City, KS, USA
| | - Reem A Mustafa
- Division of Nephrology and Hypertension, Department of Internal Medicine, Medical Center, University of Kansas, Kansas City, KS, USA.
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
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Kutky M, Cross E, Treleaven DJ, Alam A, Lanktree MB. The Impact of COVID-19 on Patients With ADPKD. Can J Kidney Health Dis 2021; 8:20543581211056479. [PMID: 34777845 PMCID: PMC8586165 DOI: 10.1177/20543581211056479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022] Open
Abstract
PURPOSE OF REVIEW Patients with autosomal dominant polycystic kidney disease (ADPKD) have kidney cysts and kidney enlargement decades before progressing to advanced chronic kidney disease (CKD), meaning patients live most of their adult life with a chronic medical condition. The coronavirus disease 2019 (COVID-19) pandemic has created common questions among patients with ADPKD. In this review, we discuss COVID-19 concerns centered around a patient with a common clinical vignette. SOURCES OF INFORMATION We performed PubMed and Google scholar searches for English, peer-reviewed studies related to "COVID-19," "ADPKD," "CKD," "tolvaptan," "angiotensin-converting enzyme inhibitors" (ACEi), "angiotensin receptor blockers" (ARB), and "vaccination." We also evaluated transplant data provided by the Ontario Trillium Gift of Life Network. METHODS Following an assessment of available literature, this narrative review addresses common questions of patients with ADPKD in the context of the COVID-19 pandemic. KEY FINDINGS Data regarding the risk of developing COVID-19 and the risk of adverse COVID-19 outcomes in patients with ADPKD remain limited, but patients with ADPKD with impaired estimated glomerular filtration rate (eGFR), kidney transplants, or on dialysis are likely at similar increased risk as those with generally defined CKD. We provide strategies to improve virtual care, which is likely to persist after the pandemic. Current evidence suggests ACEi, ARB, and tolvaptan treatment should be continued unless contraindicated due to severe illness. When available, and in the absence of a severe allergy, vaccination is recommended for all patients with ADPKD. LIMITATIONS This narrative review is limited by a paucity of high-quality data on COVID-19 outcomes in patients specifically with ADPKD. IMPLICATIONS Patients with ADPKD who have developed advanced CKD, require dialysis, or who have received a kidney transplant are at elevated risk of COVID-19 complications.
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Affiliation(s)
- Meherzad Kutky
- Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Erin Cross
- Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Darin J. Treleaven
- Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Ahsan Alam
- Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Matthew B. Lanktree
- Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada
- St. Joseph’s Healthcare Hamilton, ON, Canada
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Vera-Zertuche JM, Mancilla-Galindo J, Tlalpa-Prisco M, Aguilar-Alonso P, Aguirre-García MM, Segura-Badilla O, Lazcano-Hernández M, Rocha-González HI, Navarro-Cruz AR, Kammar-García A, Vidal-Mayo JDJ. Obesity is a strong risk factor for short-term mortality and adverse outcomes in Mexican patients with COVID-19: a national observational study. Epidemiol Infect 2021; 149:e109. [PMID: 33913410 PMCID: PMC8134888 DOI: 10.1017/s0950268821001023] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 04/03/2021] [Accepted: 04/22/2021] [Indexed: 12/14/2022] Open
Abstract
Conflicting results have been obtained through meta-analyses for the role of obesity as a risk factor for adverse outcomes in patients with coronavirus disease-2019 (COVID-19), possibly due to the inclusion of predominantly multimorbid patients with severe COVID-19. Here, we aimed to study obesity alone or in combination with other comorbidities as a risk factor for short-term all-cause mortality and other adverse outcomes in Mexican patients evaluated for suspected COVID-19 in ambulatory units and hospitals in Mexico. We performed a retrospective observational analysis in a national cohort of 71 103 patients from all 32 states of Mexico from the National COVID-19 Epidemiological Surveillance Study. Two statistical models were applied through Cox regression to create survival models and logistic regression models to determine risk of death, hospitalisation, invasive mechanical ventilation, pneumonia and admission to an intensive care unit, conferred by obesity and other comorbidities (diabetes mellitus (DM), chronic obstructive pulmonary disease, asthma, immunosuppression, hypertension, cardiovascular disease and chronic kidney disease). Models were adjusted for other risk factors. From 24 February to 26 April 2020, 71 103 patients were evaluated for suspected COVID-19; 15 529 (21.8%) had a positive test for SARS-CoV-2; 46 960 (66.1%), negative and 8614 (12.1%), pending results. Obesity alone increased adjusted mortality risk in positive patients (hazard ratio (HR) = 2.7, 95% confidence interval (CI) 2.04-2.98), but not in negative and pending-result patients. Obesity combined with other comorbidities further increased risk of death (DM: HR = 2.79, 95% CI 2.04-3.80; immunosuppression: HR = 5.06, 95% CI 2.26-11.41; hypertension: HR = 2.30, 95% CI 1.77-3.01) and other adverse outcomes. In conclusion, obesity is a strong risk factor for short-term mortality and critical illness in Mexican patients with COVID-19; risk increases when obesity is present with other comorbidities.
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Affiliation(s)
- J. M. Vera-Zertuche
- Endocrinology Department, Obesity Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - J. Mancilla-Galindo
- Unidad de Investigación UNAM-INC, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - M. Tlalpa-Prisco
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | - P. Aguilar-Alonso
- Facultad de Ciencias Químicas, Departamento de Bioquímica y Alimentos, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - M. M. Aguirre-García
- Unidad de Investigación UNAM-INC, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - O. Segura-Badilla
- Facultad de Ciencias de la Salud y de los Alimentos, Departamento de Nutrición y Salud Pública, Programa UBB Saludable, Universidad del Bío-Bío, Bío-Bío, Chile
| | - M. Lazcano-Hernández
- Facultad de Ciencias Químicas, Departamento de Bioquímica y Alimentos, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - H. I. Rocha-González
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | - A. R. Navarro-Cruz
- Facultad de Ciencias Químicas, Departamento de Bioquímica y Alimentos, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - A. Kammar-García
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
- Emergency Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - J. de J. Vidal-Mayo
- Emergency Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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