Characteristics and outcomes of hospitalised older patients with chronic

Abstract

Objective Older adults with co-morbidities have been reported to be at higher risk for adverse outcomes of coronavirus disease 2019 (COVID-19). The characteristics of COVID-19 in older patients and its clinical outcomes in different kidney disease groups are not well known.

Methods Data were retrieved from a national multicentric database supported by Turkish Society of Nephrology, which consists of retrospectively collected data between 17 April 2020 and 31 December 2020. Hospitalised patients aged 18 years or older with confirmed COVID-19 diagnosis suffering from stage 3-5 chronic kidney disease (CKD) or on maintenance haemodialysis (HD) treatment were included in the database. Non-uraemic hospitalised patients with COVID-19 were also included as the control group.

Results We included 879 patients [388 (44.1%) female, median age: 63 (IQR: 50-73) years]. The percentage of older patients in the CKD group was 68.8% (n = 188/273), in the HD group was 49.0% (n = 150/306) and in the control group was 30.4% (n = 70/300). Co-morbidities were higher in the CKD and HD groups. The rate of presentation with severe-critical disease was higher in the older CKD and HD groups (43.6%, 55.3% and 16.1%, respectively). Among older patients, the intensive care unit (ICU) admission rate was significantly higher in the CKD and HD groups than in the control group (38.8%, 37.3% and 15.7%, respectively). In-hospital mortality or death and/or ICU admission rates in the older group were significantly higher in the CKD (29.3% and 39.4%) and HD groups (26.7% and 30.1%) compared with the control group (8.6% and 17.1%). In the multivariate analysis, in-hospital mortality rates in CKD and HD groups were higher than control group [hazard ratio (HR): 4.33 (95% confidence interval [CI]: 1.53-12.26) and HR: 3.09 (95% CI: 1.04-9.17), respectively].

Conclusion Among older COVID-19 patients, in-hospital mortality is significantly higher in those with stage 3-5 CKD and on maintenance HD than older patients without CKD regardless of demographic characteristics, co-morbidities, clinical and laboratory data on admission.

C1 [Ozturk, Savas; Yildiz, Alaattin] Istanbul Univ, Istanbul Sch Med, Dept Internal Med, Div Nephrol, Istanbul, Turkey.

[Ozturk, Savas; Karadag, Serhat] Haseki Training & Res Hosp, Dept Nephrol, Istanbul, Turkey.

[Turgutalp, Kenan] Mersin Univ, Educ & Res Hosp, Fac Med, Div Nephrol,Dept Internal Med, Mersin, Turkey.

[Arici, Mustafa] Hacettepe Univ, Fac Med, Dept Nephrol, Ankara, Turkey.

[Gok, Mahmut; Sahin, Gulizar; Odabas, Ali Riza] Univ Hlth Sci, Sultan Abdulhamid Han Training & Res Hosp, Dept Nephrol, Istanbul, Turkey.

[Islam, Mahmud] Zonguldak Ataturk State Hosp, Dept Nephrol, Zonguldak, Turkey.

[Altiparmak, Mehmet Riza] Istanbul Univ Cerrahpasa, Cerrahpasa Fac Med, Dept Internal Med, Div Nephrol, Istanbul, Turkey.

[Aydin, Zeki] Darica Farabi Training & Res Hosp, Dept Nephrol, Kocaeli, Turkey.

[Doner, Baris] Bursa City Hosp, Dept Nephrol, Bursa, Turkey.

[Eren, Necmi] Kocaeli Univ, Fac Med, Dept Nephrol, Kocaeli, Turkey.

[Sengul, Erkan] Hlth Sci Univ, Kocaeli Derince Educ & Res Hosp, Div Nephrol, Kocaeli, Turkey.

[Ozler, Tuba Elif] Kanuni Sultan Suleyman Res & Training Hosp, Dept Internal Med, Div Nephrol, Istanbul, Turkey.

[Dheir, Hamad] Sakarya Univ, Educ & Res Hosp, Fac Med, Div Nephrol,Dept Internal Med, Sakarya, Turkey.

[Pembegul, Irem] Malatya Turgut Ozal Univ, Dept Nephrol, Malatya, Turkey.

[Taymez, Dilek Guven] Kocaeli State Hosp, Dept Nephrol & Dialysis, Kocaeli, Turkey.

[Sahin, Garip] Eskisehir Osmangazi Univ, Fac Med, Dept Internal Med, Div Nephrol, Eskisehir, Turkey.

[Bakirdogen, Serkan] Canakkale Onsekiz Mart Univ, Sch Med, Dept Internal Med, Div Nephrol, Canakkale, Turkey.

[Dolarslan, Murside Esra] Univ Hlth Sci, Trabzon Kanuni Educ & Res Hosp, Div Nephrol, Trabzon, Turkey.

[Soypacaci, Zeki] Izmir Katip Celebi Univ, Ataturk Educ & Res Hosp, Dept Internal Med, Div Nephrol, Izmir, Turkey.

[Hur, Ender] Merkezefendi State Hosp, Nephrol Clin, Manisa, Turkey.

[Kara, Ekrem] Recep Tayyip Erdogan Univ, Fac Med, Dept Internal Med, Div Nephrol, Rize, Turkey.

[Basturk, Taner] Hlth Sci Univ, Sisli Hamidiye Etfal Educ & Res Hosp, Dept Nephrol, Istanbul, Turkey.

[Ogutmen, Melike Betul] Univ Hlth Sci, Haydarpasa Numune Educ & Res Hosp, Dept Nephrol, Istanbul, Turkey.

[Gorgulu, Numan] Univ Hlth Sci, Bagcilar Training & Res Hosp, Dept Internal Med, Div Nephrol, Istanbul, Turkey.

[Sahin, Idris] Inonu Univ, Sch Med, Turgut Ozal Med Ctr, Div Nephrol,Dept Internal Med, Malatya, Turkey.

[Ayli, Mehmet Deniz] Univ Hlth Sci, Diskapi Yildirim Beyazit Educ & Res Hosp, Dept Nephrol, Ankara, Turkey.

[Tuglular, Zubeyde Serhan] Marmara Univ, Pendik Educ & Res Hosp, Sch Med, Dept Internal Med,Div Nephrol, Istanbul, Turkey.

[Tokgoz, Bulent] Erciyes Univ, Sch Med, Dept Nephrol, Kayseri, Turkey.

[Tonbul, Halil Zeki] Necmettin Erbakan Univ, Dept Internal Med, Div Nephrol, Konya, Turkey.

[Sezer, Siren] Atilim Univ, Fac Med, Dept Internal Med & Nephrol, Ankara, Turkey.

[Ates, Kenan] Ankara Univ, Dept Nephrol, Fac Med, Ankara, Turkey.