Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (11): 68-73.doi: 10.6040/j.issn.1671-7554.0.2023.0386

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Risk factors of mortality of maintenance hemodialysis patients with COVID-19 pneumonia

WANG Yuanyuan1,2, SUN Yun1,2   

  1. 1. Department of Nephrology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China;
    2. Multidisciplinary Innovation Center for Nephrology of the Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Published:2023-12-12

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Abstract: Objective To explore the risk factors of in-hospital mortality of maintenance hemodialysis(MHD)patients with COVID-19 pneumonia. Methods A case-control study was conducted on MHD patients admitted due to COVID-19 pneumonia during Dec. 1, 2022 and Feb. 28, 2023. A total of 54 patients were included in the study. According to whether the patients died during the hospitalization, they were divided into two groups: the death group(n=21)and the survival group(n=33). The patients had a mean age of(66.5±11.4)years, with a male proportion of 74.1%. The clinical and laboratory characteristics of the two groups were compared, and the multivariable Logistic regression models were applied to identify the independent risk factors of in-hospital mortality. Results Mean survival time of patients in the death group was(8.8±6.7)days. The causes of death were severe pneumonia secondary to COVID-19(15 cases, 71.4%), cardiovascular disease(4 cases, 19.0%), and cerebrovascular disease(2 cases, 9.5%). Compared with the survival group, more patients in the death group were ≥75 years of age(P=0.024); had a positive history of diabetes mellitus(P=0.030); had lower albumin(ALB)level in the 6 months before COVID-19 pneumonia(P=0.046); had higher levels of D-dimer, white blood cell(WBC)count, neutrophil(NEUT)count, C-reactive protein(CRP), interleukin-6(IL-6)and procalcitonin(PCT)within 24 hours of admission(all P<0.05); had lower levels of lymphocyte(LYM)count, ALB and prealbumin(PA)(all P<0.05). Multivariable Logistic regression analysis showed that ≥75 years of age and elevated IL-6 level were independent risk factors of in-hospital mortality. Elevated IL-6 level was independent influencing factor of oxygen partial pressure ≤60 mmHg and progression of chest imaging lesions >50% during hospitalization. Conclusion MHD patients with COVID-19 pneumonia have a high mortality during hospitalization, most of whom die of severe pneumonia. Advanced age, history of diabetes mellitus, poor nutritional status, high inflammatory levels and hypercoagulability, especially IL-6 level, are risk factors of mortality in these patients.

Key words: COVID-19 pneumonia, Dialysis, Advanced age, Cytokine storm, Risk factor

CLC Number: 

  • R692.5
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