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

<h3>Context </h3> <p>Patients on maintenance dialysis are more susceptible to COVID-19 and its severe form. We studied the mortality and associated risks of COVID-19 infection in dialysis patients in the state of Qatar. </p> <h3>Methods </h3> <p>This was an...

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Main Author: Tarek Abdel Latif Ghonimi (16328413) (author)
Other Authors: Mohamad Mahmood Alkad (16328415) (author), Essa Abdulla Abuhelaiqa (16328440) (author), Muftah M. Othman (16328442) (author), Musab Ahmed Elgaali (16328443) (author), Rania Abdelaziz M. Ibrahim (16328444) (author), Shajahan M. Joseph (16328446) (author), Hassan Ali Al-Malki, (16328448) (author), Abdullah Ibrahim Hamad (16328449) (author)
Published: 2023
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author Tarek Abdel Latif Ghonimi (16328413)
author2 Mohamad Mahmood Alkad (16328415)
Essa Abdulla Abuhelaiqa (16328440)
Muftah M. Othman (16328442)
Musab Ahmed Elgaali (16328443)
Rania Abdelaziz M. Ibrahim (16328444)
Shajahan M. Joseph (16328446)
Hassan Ali Al-Malki, (16328448)
Abdullah Ibrahim Hamad (16328449)
author2_role author
author
author
author
author
author
author
author
author_facet Tarek Abdel Latif Ghonimi (16328413)
Mohamad Mahmood Alkad (16328415)
Essa Abdulla Abuhelaiqa (16328440)
Muftah M. Othman (16328442)
Musab Ahmed Elgaali (16328443)
Rania Abdelaziz M. Ibrahim (16328444)
Shajahan M. Joseph (16328446)
Hassan Ali Al-Malki, (16328448)
Abdullah Ibrahim Hamad (16328449)
author_role author
dc.creator.none.fl_str_mv Tarek Abdel Latif Ghonimi (16328413)
Mohamad Mahmood Alkad (16328415)
Essa Abdulla Abuhelaiqa (16328440)
Muftah M. Othman (16328442)
Musab Ahmed Elgaali (16328443)
Rania Abdelaziz M. Ibrahim (16328444)
Shajahan M. Joseph (16328446)
Hassan Ali Al-Malki, (16328448)
Abdullah Ibrahim Hamad (16328449)
dc.date.none.fl_str_mv 2023-06-14T07:53:21Z
dc.identifier.none.fl_str_mv 10.1371/journal.pone.0254246
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Mortality_and_associated_risk_factors_of_COVID-19_infection_in_dialysis_patients_in_Qatar_A_nationwide_cohort_study/23513967
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Human society
Demography
COVID-19 infection
dialysis
Nephrology
kidney disease
PCR swab Test
Qatar
dc.title.none.fl_str_mv Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Context </h3> <p>Patients on maintenance dialysis are more susceptible to COVID-19 and its severe form. We studied the mortality and associated risks of COVID-19 infection in dialysis patients in the state of Qatar. </p> <h3>Methods </h3> <p>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. </p> <h3>Results </h3> <p>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 COVID19 than females (9% versus 4.5% respectively; p<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 = <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<0.001) and using inotropes(HR 19.17, CI 95% (11.57–718.5), p<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)]. </p> <h3>Conclusion </h3> <p>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. </p> <h2>Other Information</h2> <p>Published in: PLoS ONE <br> License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br> See article on publisher's website: <a href="http://dx.doi.org/10.1371/journal.pone.0254246" target="_blank">http://dx.doi.org/10.1371/journal.pone.0254246 </a></p>
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identifier_str_mv 10.1371/journal.pone.0254246
network_acronym_str Manara2
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oai_identifier_str oai:figshare.com:article/23513967
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spelling Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort studyTarek Abdel Latif Ghonimi (16328413)Mohamad Mahmood Alkad (16328415)Essa Abdulla Abuhelaiqa (16328440)Muftah M. Othman (16328442)Musab Ahmed Elgaali (16328443)Rania Abdelaziz M. Ibrahim (16328444)Shajahan M. Joseph (16328446)Hassan Ali Al-Malki, (16328448)Abdullah Ibrahim Hamad (16328449)Biomedical and clinical sciencesClinical sciencesHuman societyDemographyCOVID-19 infectiondialysisNephrologykidney diseasePCR swab TestQatar<h3>Context </h3> <p>Patients on maintenance dialysis are more susceptible to COVID-19 and its severe form. We studied the mortality and associated risks of COVID-19 infection in dialysis patients in the state of Qatar. </p> <h3>Methods </h3> <p>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. </p> <h3>Results </h3> <p>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 COVID19 than females (9% versus 4.5% respectively; p<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 = <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<0.001) and using inotropes(HR 19.17, CI 95% (11.57–718.5), p<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)]. </p> <h3>Conclusion </h3> <p>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. </p> <h2>Other Information</h2> <p>Published in: PLoS ONE <br> License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br> See article on publisher's website: <a href="http://dx.doi.org/10.1371/journal.pone.0254246" target="_blank">http://dx.doi.org/10.1371/journal.pone.0254246 </a></p>2023-06-14T07:53:21ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1371/journal.pone.0254246https://figshare.com/articles/journal_contribution/Mortality_and_associated_risk_factors_of_COVID-19_infection_in_dialysis_patients_in_Qatar_A_nationwide_cohort_study/23513967CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/235139672023-06-14T07:53:21Z
spellingShingle Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study
Tarek Abdel Latif Ghonimi (16328413)
Biomedical and clinical sciences
Clinical sciences
Human society
Demography
COVID-19 infection
dialysis
Nephrology
kidney disease
PCR swab Test
Qatar
status_str publishedVersion
title Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study
title_full Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study
title_fullStr Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study
title_full_unstemmed Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study
title_short Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study
title_sort Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study
topic Biomedical and clinical sciences
Clinical sciences
Human society
Demography
COVID-19 infection
dialysis
Nephrology
kidney disease
PCR swab Test
Qatar