Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study

This was an observational, analytical, retrospective, nationwide study. We included all adult patients on maintenance dialysis therapy who tested positive for COVID-19 (PCR assay of the nasopharyngeal swab) during the period from February 1, 2020, to July 19, 2020. Our primary outcome was to study t...

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Published in:PloS one 2021-07, Vol.16 (7), p.e0254246-e0254246
Main Authors: Ghonimi, Tarek Abdel Latif, Alkad, Mohamad Mahmood, Abuhelaiqa, Essa Abdulla, Othman, Muftah M, Elgaali, Musab Ahmed, Ibrahim, Rania Abdelaziz M, Joseph, Shajahan M, Al-Malki, Hassan Ali, Hamad, Abdullah Ibrahim
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Chronic obstructive pulmonary disease
Cohort analysis
Coronaviruses
Cough
COVID-19
Death
Demographics
Demography
Dialysis
Electronic health records
Electronic medical records
Evaluation
Fever
Fibrillation
Health risks
Hemodialysis
Hemodialysis patients
Hypoxia
Infections
Maintenance
Mechanical ventilation
Medical research
Medicine and Health Sciences
Mortality
Multivariate analysis
Patient outcomes
Patients
People and Places
Peritoneal dialysis
Peritoneum
Qatar
Regression analysis
Risk analysis
Risk factors
Ventilation
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cited_by cdi_FETCH-LOGICAL-c669t-48f50ae455b41184ce42c26e6d59c07fbab57d3aff6f0b8e857dfe6e95f443623
cites cdi_FETCH-LOGICAL-c669t-48f50ae455b41184ce42c26e6d59c07fbab57d3aff6f0b8e857dfe6e95f443623
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container_title PloS one
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creator Ghonimi, Tarek Abdel Latif
Alkad, Mohamad Mahmood
Abuhelaiqa, Essa Abdulla
Othman, Muftah M
Elgaali, Musab Ahmed
Ibrahim, Rania Abdelaziz M
Joseph, Shajahan M
Al-Malki, Hassan Ali
Hamad, Abdullah Ibrahim
description This was an observational, analytical, retrospective, nationwide study. We included all adult patients on maintenance dialysis therapy who tested positive for COVID-19 (PCR assay of the nasopharyngeal swab) during the period from February 1, 2020, to July 19, 2020. Our primary outcome was to study the mortality of COVID-19 in dialysis patients in Qatar and risk factors associated with it. Our secondary objectives were to study incidence and severity of COVID-19 in dialysis patients and comparing outcomes between hemodialysis and peritoneal dialysis patients. Patient demographics and clinical features were collected from a national electronic medical record. Univariate Cox regression analysis was performed to evaluate potential risk factors for mortality in our cohort. 76 out of 1064 dialysis patients were diagnosed with COVID-19 (age 56±13.6, 56 hemodialysis and 20 peritoneal dialysis, 56 males). During the study period, 7.1% of all dialysis patients contracted COVID-19. Male dialysis patients had double the incidence of COVID-19 than females (9% versus 4.5% respectively; p
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We included all adult patients on maintenance dialysis therapy who tested positive for COVID-19 (PCR assay of the nasopharyngeal swab) during the period from February 1, 2020, to July 19, 2020. Our primary outcome was to study the mortality of COVID-19 in dialysis patients in Qatar and risk factors associated with it. Our secondary objectives were to study incidence and severity of COVID-19 in dialysis patients and comparing outcomes between hemodialysis and peritoneal dialysis patients. Patient demographics and clinical features were collected from a national electronic medical record. Univariate Cox regression analysis was performed to evaluate potential risk factors for mortality in our cohort. 76 out of 1064 dialysis patients were diagnosed with COVID-19 (age 56±13.6, 56 hemodialysis and 20 peritoneal dialysis, 56 males). During the study period, 7.1% of all dialysis patients contracted COVID-19. Male dialysis patients had double the incidence of COVID-19 than females (9% versus 4.5% respectively; p&lt;0.01). The most common symptoms on presentation were fever (57.9%), cough (56.6%), and shortness of breath (25%). Pneumonia was diagnosed in 72% of dialysis patients with COVID-19. High severity manifested as 25% of patients requiring admission to the intensive care unit, 18.4% had ARDS, 17.1% required mechanical ventilation, and 14.5% required inotropes. The mean length of hospital stay was 19.2 ± -12 days. Mortality due to COVID-19 among our dialysis cohort was 15%. Univariate Cox regression analysis for risk factors associated with COVID-19-related death in dialysis patients showed significant increases in risks with age (OR 1.077, CI 95%(1.018-1.139), p = 0.01), CHF and COPD (both same OR 8.974, CI 95% (1.039-77.5), p = 0.046), history of DVT (OR 5.762, CI 95% (1.227-27.057), p = 0.026), Atrial fibrillation (OR 7.285, CI 95%(2.029-26.150), p = 0.002), hypoxia (OR: 16.6; CI 95%(3.574-77.715), p = &lt;0.001), ICU admission (HR30.8, CI 95% (3.9-241.2), p = 0.001), Mechanical ventilation (HR 50.07 CI 95% (6.4-391.2)), p&lt;0.001) and using inotropes(HR 19.17, CI 95% (11.57-718.5), p&lt;0.001). In a multivariate analysis, only ICU admission was found to be significantly associated with death [OR = 32.8 (3.5-305.4), p = 0.002)]. This is the first study to be conducted at a national level in Qatar exploring COVID-19 in a dialysis population. Dialysis patients had a high incidence of COVID-19 infection and related mortality compared to previous reports of the general population in the state of Qatar (7.1% versus 4% and 15% versus 0.15% respectively). We also observed a strong association between death related to COVID-19 infection in dialysis patients and admission to ICU.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0254246</identifier><identifier>PMID: 34293004</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Biology and Life Sciences ; Chronic obstructive pulmonary disease ; Cohort analysis ; Coronaviruses ; Cough ; COVID-19 ; Death ; Demographics ; Demography ; Dialysis ; Electronic health records ; Electronic medical records ; Evaluation ; Fever ; Fibrillation ; Health risks ; Hemodialysis ; Hemodialysis patients ; Hypoxia ; Infections ; Maintenance ; Mechanical ventilation ; Medical research ; Medicine and Health Sciences ; Mortality ; Multivariate analysis ; Patient outcomes ; Patients ; People and Places ; Peritoneal dialysis ; Peritoneum ; Qatar ; Regression analysis ; Risk analysis ; Risk factors ; Ventilation</subject><ispartof>PloS one, 2021-07, Vol.16 (7), p.e0254246-e0254246</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Ghonimi et al. 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We included all adult patients on maintenance dialysis therapy who tested positive for COVID-19 (PCR assay of the nasopharyngeal swab) during the period from February 1, 2020, to July 19, 2020. Our primary outcome was to study the mortality of COVID-19 in dialysis patients in Qatar and risk factors associated with it. Our secondary objectives were to study incidence and severity of COVID-19 in dialysis patients and comparing outcomes between hemodialysis and peritoneal dialysis patients. Patient demographics and clinical features were collected from a national electronic medical record. Univariate Cox regression analysis was performed to evaluate potential risk factors for mortality in our cohort. 76 out of 1064 dialysis patients were diagnosed with COVID-19 (age 56±13.6, 56 hemodialysis and 20 peritoneal dialysis, 56 males). During the study period, 7.1% of all dialysis patients contracted COVID-19. Male dialysis patients had double the incidence of COVID-19 than females (9% versus 4.5% respectively; p&lt;0.01). The most common symptoms on presentation were fever (57.9%), cough (56.6%), and shortness of breath (25%). Pneumonia was diagnosed in 72% of dialysis patients with COVID-19. High severity manifested as 25% of patients requiring admission to the intensive care unit, 18.4% had ARDS, 17.1% required mechanical ventilation, and 14.5% required inotropes. The mean length of hospital stay was 19.2 ± -12 days. Mortality due to COVID-19 among our dialysis cohort was 15%. Univariate Cox regression analysis for risk factors associated with COVID-19-related death in dialysis patients showed significant increases in risks with age (OR 1.077, CI 95%(1.018-1.139), p = 0.01), CHF and COPD (both same OR 8.974, CI 95% (1.039-77.5), p = 0.046), history of DVT (OR 5.762, CI 95% (1.227-27.057), p = 0.026), Atrial fibrillation (OR 7.285, CI 95%(2.029-26.150), p = 0.002), hypoxia (OR: 16.6; CI 95%(3.574-77.715), p = &lt;0.001), ICU admission (HR30.8, CI 95% (3.9-241.2), p = 0.001), Mechanical ventilation (HR 50.07 CI 95% (6.4-391.2)), p&lt;0.001) and using inotropes(HR 19.17, CI 95% (11.57-718.5), p&lt;0.001). In a multivariate analysis, only ICU admission was found to be significantly associated with death [OR = 32.8 (3.5-305.4), p = 0.002)]. This is the first study to be conducted at a national level in Qatar exploring COVID-19 in a dialysis population. Dialysis patients had a high incidence of COVID-19 infection and related mortality compared to previous reports of the general population in the state of Qatar (7.1% versus 4% and 15% versus 0.15% respectively). We also observed a strong association between death related to COVID-19 infection in dialysis patients and admission to ICU.</description><subject>Biology and Life Sciences</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Cohort analysis</subject><subject>Coronaviruses</subject><subject>Cough</subject><subject>COVID-19</subject><subject>Death</subject><subject>Demographics</subject><subject>Demography</subject><subject>Dialysis</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Evaluation</subject><subject>Fever</subject><subject>Fibrillation</subject><subject>Health risks</subject><subject>Hemodialysis</subject><subject>Hemodialysis patients</subject><subject>Hypoxia</subject><subject>Infections</subject><subject>Maintenance</subject><subject>Mechanical ventilation</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>People and Places</subject><subject>Peritoneal dialysis</subject><subject>Peritoneum</subject><subject>Qatar</subject><subject>Regression analysis</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Ventilation</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>COVID</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNqNk9uO0zAQhiMEYpeFN0DCEhKCixY7PiTZC6SqnCotWnHaW2vi2K1LGhfbAfr2ONuANmgvkC9iTz7_M_7tybLHBM8JLcjLret9B-187zo9xzlnORN3slNS0Xwmckzv3pifZA9C2GLMaSnE_eyEsryiGLPTLH5wPkJr4wFB1yAIwSkLUTfI2_ANGVDR-YCcQcvLq9XrGamQ7YxW0bouzVBjoT0EG9AeotVdDEPwI0Tw52iBOhi4n7bRSLlNyoRC7JvDw-yegTboR-P3LPv69s2X5fvZxeW71XJxMVNCVHHGSsMxaMZ5zQgpmdIsV7nQouGVwoWpoeZFQ8EYYXBd6jKtjBa64oYxKnJ6lj056u5bF-RoWJA554xSUYoyEasj0TjYyr23O_AH6cDK64Dzawk-WtVqSeoCK6yxamrCcE2SkxWhDaZAlWGUJa1XY7a-3ulGJTc8tBPR6Z_ObuTa_ZBlXhUFJ0ng-Sjg3fdehyh3NijdttBp11_XzQmhmA51P_0Hvf10I7WGdIB0by7lVYOoXKTqKaVlMdQ9v4VKo9E7q9LrMjbFJxteTDYkJupfcQ19CHL1-dP_s5dXU_bZDXajoY2b4Np-eENhCrIjqLwLwWvz12SC5dAcf9yQQ3PIsTnob_Am_-g</recordid><startdate>20210722</startdate><enddate>20210722</enddate><creator>Ghonimi, Tarek Abdel Latif</creator><creator>Alkad, Mohamad Mahmood</creator><creator>Abuhelaiqa, Essa Abdulla</creator><creator>Othman, Muftah M</creator><creator>Elgaali, Musab Ahmed</creator><creator>Ibrahim, Rania Abdelaziz M</creator><creator>Joseph, Shajahan M</creator><creator>Al-Malki, Hassan Ali</creator><creator>Hamad, Abdullah Ibrahim</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>COVID</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-0009-5823</orcidid><orcidid>https://orcid.org/0000-0003-4677-7686</orcidid><orcidid>https://orcid.org/0000-0003-4241-3746</orcidid></search><sort><creationdate>20210722</creationdate><title>Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study</title><author>Ghonimi, Tarek Abdel Latif ; 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Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Meteorological &amp; Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agriculture Science Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest Biological Science Journals</collection><collection>Engineering Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest advanced technologies &amp; aerospace journals</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials science collection</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ghonimi, Tarek Abdel Latif</au><au>Alkad, Mohamad Mahmood</au><au>Abuhelaiqa, Essa Abdulla</au><au>Othman, Muftah M</au><au>Elgaali, Musab Ahmed</au><au>Ibrahim, Rania Abdelaziz M</au><au>Joseph, Shajahan M</au><au>Al-Malki, Hassan Ali</au><au>Hamad, Abdullah Ibrahim</au><au>Najafi, Bijan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study</atitle><jtitle>PloS one</jtitle><date>2021-07-22</date><risdate>2021</risdate><volume>16</volume><issue>7</issue><spage>e0254246</spage><epage>e0254246</epage><pages>e0254246-e0254246</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>This was an observational, analytical, retrospective, nationwide study. We included all adult patients on maintenance dialysis therapy who tested positive for COVID-19 (PCR assay of the nasopharyngeal swab) during the period from February 1, 2020, to July 19, 2020. Our primary outcome was to study the mortality of COVID-19 in dialysis patients in Qatar and risk factors associated with it. Our secondary objectives were to study incidence and severity of COVID-19 in dialysis patients and comparing outcomes between hemodialysis and peritoneal dialysis patients. Patient demographics and clinical features were collected from a national electronic medical record. Univariate Cox regression analysis was performed to evaluate potential risk factors for mortality in our cohort. 76 out of 1064 dialysis patients were diagnosed with COVID-19 (age 56±13.6, 56 hemodialysis and 20 peritoneal dialysis, 56 males). During the study period, 7.1% of all dialysis patients contracted COVID-19. Male dialysis patients had double the incidence of COVID-19 than females (9% versus 4.5% respectively; p&lt;0.01). The most common symptoms on presentation were fever (57.9%), cough (56.6%), and shortness of breath (25%). Pneumonia was diagnosed in 72% of dialysis patients with COVID-19. High severity manifested as 25% of patients requiring admission to the intensive care unit, 18.4% had ARDS, 17.1% required mechanical ventilation, and 14.5% required inotropes. The mean length of hospital stay was 19.2 ± -12 days. Mortality due to COVID-19 among our dialysis cohort was 15%. Univariate Cox regression analysis for risk factors associated with COVID-19-related death in dialysis patients showed significant increases in risks with age (OR 1.077, CI 95%(1.018-1.139), p = 0.01), CHF and COPD (both same OR 8.974, CI 95% (1.039-77.5), p = 0.046), history of DVT (OR 5.762, CI 95% (1.227-27.057), p = 0.026), Atrial fibrillation (OR 7.285, CI 95%(2.029-26.150), p = 0.002), hypoxia (OR: 16.6; CI 95%(3.574-77.715), p = &lt;0.001), ICU admission (HR30.8, CI 95% (3.9-241.2), p = 0.001), Mechanical ventilation (HR 50.07 CI 95% (6.4-391.2)), p&lt;0.001) and using inotropes(HR 19.17, CI 95% (11.57-718.5), p&lt;0.001). In a multivariate analysis, only ICU admission was found to be significantly associated with death [OR = 32.8 (3.5-305.4), p = 0.002)]. This is the first study to be conducted at a national level in Qatar exploring COVID-19 in a dialysis population. Dialysis patients had a high incidence of COVID-19 infection and related mortality compared to previous reports of the general population in the state of Qatar (7.1% versus 4% and 15% versus 0.15% respectively). We also observed a strong association between death related to COVID-19 infection in dialysis patients and admission to ICU.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34293004</pmid><doi>10.1371/journal.pone.0254246</doi><tpages>e0254246</tpages><orcidid>https://orcid.org/0000-0003-0009-5823</orcidid><orcidid>https://orcid.org/0000-0003-4677-7686</orcidid><orcidid>https://orcid.org/0000-0003-4241-3746</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1932-6203
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issn 1932-6203
1932-6203
language eng
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source Open Access: PubMed Central; Publicly Available Content (ProQuest); Coronavirus Research Database
subjects Biology and Life Sciences
Chronic obstructive pulmonary disease
Cohort analysis
Coronaviruses
Cough
COVID-19
Death
Demographics
Demography
Dialysis
Electronic health records
Electronic medical records
Evaluation
Fever
Fibrillation
Health risks
Hemodialysis
Hemodialysis patients
Hypoxia
Infections
Maintenance
Mechanical ventilation
Medical research
Medicine and Health Sciences
Mortality
Multivariate analysis
Patient outcomes
Patients
People and Places
Peritoneal dialysis
Peritoneum
Qatar
Regression analysis
Risk analysis
Risk factors
Ventilation
title Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study
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