Age and multimorbidities as poor prognostic factors for COVID-19 in hemodialysis: a Lebanese national study

• Main Authors: Mabel Aoun, Rabab Khalil, Walid Mahfoud, Haytham Fatfat, Line Bou Khalil, Rashad Alameddine, Nabil Afiouni, Issam Ibrahim, Mohamad Hassan, Haytham Zarzour, Ali Jebai, Nina Mourad Khalil, Luay Tawil, Zeina Mechref, Zuhair El Imad, Fadia Chamma, Ayman Khalil, Sandy Zeidan, Balsam El Ghoul, Georges Dahdah, Sarah Mouawad, Hiba Azar, Kamal Abou Chahine, Siba Kallab, Bashir Moawad, Ahmad Fawaz, Joseph Homsi, Carmen Tabaja, Maya Delbani, Rami Kallab, Hassan Hoballah, Wahib Haykal, Najat Fares, Walid Rahal, Wael Mroueh, Mohammed Youssef, Jamale Rizkallah, Ziad Sebaaly, Antoine Dfouni, Norma Ghosn, Nagi Nawfal, Walid Abou Jaoude, Nadine Bassil, Therese Maroun, Nabil Bassil, Chadia Beaini, Boutros Haddad, Elie Moubarak, Houssam Rabah, Amer Attieh, Serge Finianos, Dania Chelala
• Format: Article
• Language: English
• Published: BMC 2021-02-01
• Series: BMC Nephrology
• Subjects: COVID-19; Hemodialysis; Mortality; Multimorbidities; SARS-CoV-2; National study
• Online Access: https://doi.org/10.1186/s12882-021-02270-9

Abstract Background Hemodialysis patients with COVID-19 have been reported to be at higher risk for death than the general population. Several prognostic factors have been identified in the studies from Asian, European or American countries. This is the first national Lebanese study assessing the factors associated with SARS-CoV-2 mortality in hemodialysis patients. Methods This is an observational study that included all chronic hemodialysis patients in Lebanon who were tested positive for SARS-CoV-2 from 31st March to 1st November 2020. Data on demographics, comorbidities, admission to hospital and outcome were collected retrospectively from the patients’ medical records. A binary logistic regression analysis was performed to assess risk factors for mortality. Results A total of 231 patients were included. Mean age was 61.46 ± 13.99 years with a sex ratio of 128 males to 103 females. Around half of the patients were diabetics, 79.2% presented with fever. A total of 115 patients were admitted to the hospital, 59% of them within the first day of diagnosis. Hypoxia was the major reason for hospitalization. Death rate was 23.8% after a median duration of 6 (IQR, 2 to 10) days. Adjusted regression analysis showed a higher risk for death among older patients (odds ratio = 1.038; 95% confidence interval: 1.013, 1.065), patients with heart failure (odds ratio = 4.42; 95% confidence interval: 2.06, 9.49), coronary artery disease (odds ratio = 3.27; 95% confidence interval: 1.69, 6.30), multimorbidities (odds ratio = 1.593; 95% confidence interval: 1.247, 2.036), fever (odds ratio = 6.66; 95% confidence interval: 1.94, 27.81), CRP above 100 mg/L (odds ratio = 4.76; 95% confidence interval: 1.48, 15.30), and pneumonia (odds ratio = 19.18; 95% confidence interval: 6.47, 56.83). Conclusions This national study identified older age, coronary artery disease, heart failure, multimorbidities, fever and pneumonia as risk factors for death in patients with COVID-19 on chronic hemodialysis. The death rate was comparable to other countries and estimated at 23.8%.