Outcomes of COVID-19 among Patients on In-Center Hemodialysis: An Experience from the Epicenter in South Korea
Abstract
:1. Introduction
2. Methods
2.1. Patients
2.2. Laboratory Confirmation of SARS-CoV-2
2.3. Data Collection
2.4. Criteria for Quarantine Release and Discharge
2.5. Statistical Analysis
3. Results
3.1. Clinical Characteristics
3.2. Clinical Findings
3.3. Treatments and Outcomes
4. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variable | Patients (n = 14) |
---|---|
Age | |
Mean age (range), years | 63.5 ± 14.5 (40.0–88.0) |
Distribution, n (%) | |
<50 years | 2 (14.3) |
50–64 years | 8 (57.1) |
65–79 years | 1 (7.1) |
≥80 years | 3 (21.4) |
Sex, n (%) | |
Male/Female | 6 (42.9)/8 (57.1) |
Mean duration of dialysis (range), years | 4.7 ± 5.3 (0–21.0) |
Cause of ESRD, n (%) | |
Diabetes mellitus | 7 (50.0) |
Hypertension | 2 (14.3) |
Others | 5 (35.7) |
Body mass index, kg/m2 | 23.6 ± 4.3 |
Comorbidities, n (%) | |
Cardiovascular disease | 2 (14.2) |
Cerebrovascular disease | 3 (21.4) |
Chronic obstructive pulmonary disease | 0 |
Diabetes mellitus | 7 (50.0) |
Hypertension | 11 (78.6) |
Cancer | 2 (14.3) |
Charlson Comorbidity Index | 5.6 ± 1.8 |
History of contacts with patient with COVID-19, n (%) | 4 (28.6) |
Symptoms | |
Cough | 7 (50.0) |
Sputum | 3 (21.4) |
Dyspnea | 5 (35.7) |
Sore throat | 1 (7.1) |
Rhinorrhea | 2 (14.3) |
Myalgia | 2 (14.3) |
Fatigue | 4 (28.6) |
Nausea, vomiting, or diarrhea | 2 (14.3) |
Mean duration from symptom onset to diagnosis, days | 2.6 ± 2.3 |
Mean duration from symptom onset to admission, days | 3.5 ± 2.8 |
Parameter | Patients (n = 14) |
---|---|
Vital signs | |
Systolic blood pressure, mmHg | 136.5 ± 24.7 |
Diastolic blood pressure, mmHg | 76.8 ± 15.6 |
Heart rate >100 beats per min, n (%) | 2 (14.3) |
Respiratory rate ≥20 breaths per min, n (%) | 5 (35.7) |
Body temperature ≥ 38 °C, n (%) | 3 (21.4) |
Laboratory results (normal range) | |
White blood cell count, ×103/µL (4.0–10.0) | 5.8 ± 2.1 |
Lymphocyte count, ×103/µL (1.0–4.5) | 1.1 ± 0.5 |
Hemoglobin, g/dL (13.0–18.0) | 10.5 ± 1.4 |
Platelet count, ×103/µL (130–400) | 162.1 ± 74.0 |
C-reactive protein, mg/dL (<0.5) | 6.1 (3.0–8.8) |
Ferritin, ng/mL (n = 9; 30–400) | 472.0 (292.4–1693.2) |
Procalcitonin, ng/mL (n = 9; <0.05) | 0.6 (0.3–1.0) |
Albumin, g/dL (3.5–5.2) | 3.3 ± 0.7 |
Alanine aminotransferase, U/L (<41) | 14.5 (11.5–18.0) |
Aspartate aminotransferase, U/L (<40) | 19.0 (16.0–33.8) |
Lactate dehydrogenase, U/L (135–250) | 264.5 (196.0–401.0) |
Creatine phosphokinase, U/L (n = 10; 26–192) | 210.4 ± 188.8 |
Lactic acid, mmol/L (n = 8; 0.5–1.6) | 1.3 (1.1–2.2) |
Prothrombin time, sec (n = 12; 10–14) | 13.1 (13.0–13.9) |
Activated partial thromboplastin time, s (n = 12; 20–35) | 37.8 (36.3–40.9) |
D-dimer, µg/mL (n = 7; <0.5) | 1.7 (1.0–3.8) |
Chest radiography findings, n (%) | |
Clear | 4 (28.6) |
Unilateral infiltration | 3 (21.4) |
Bilateral infiltration | 7 (50.0) |
Pleural effusion | 2 (14.3) |
Patients (n = 14) | |
---|---|
Treatment, n (%) | |
Low-flow oxygen therapy | 4 (28.6) |
High-flow oxygen therapy | 2 (14.3) |
Invasive mechanical ventilation | 4 (28.6) |
ECMO | 1 (7.1) |
CRRT | 4 (28.6) |
Lopinavir and ritonavir | 14 (100.0) |
Hydroxychloroquine | 7 (50.0) |
Others | |
Antibiotics treatment | 13 (92.9) |
Antifungal treatment | 2 (14.3) |
Glucocorticoids | 3 (21.4) |
Intravenous immunoglobulin therapy | 1 (7.1) |
Vasopressors | 4 (28.6) |
Events during hemodialysis, n (%) | |
Hypotension | 3 (21.4) |
Dialysis vascular access occlusion | 3 (21.4) |
Arrhythmia | 1 (7.1) |
Patients (n = 14) | |
---|---|
Outcomes | |
Median length of stay (IQR), days | |
In hospital | 22.0 (14.0–30.0) |
In ICU (n = 5) | 6.0 (5.0–27.0) |
Median duration of positive results following COVID-19 test (IQR), days | 21.0 (12.0–30.0) |
Median duration of mechanical ventilation (IQR), days (n = 4) | 14.0 (4.0–28.0) |
Median duration of ECMO, days (n = 1) | 3 |
Median duration of CRRT (IQR), days (n = 4) | 8.5 (3.0–25.0) |
Died in the hospital, n (%) | 2 (14.3) |
Discharged from the hospital, n (%) | 9 (64.3) |
Remained in the hospital, n (%) | 3 (21.4) |
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Jung, H.-Y.; Lim, J.-H.; Kang, S.H.; Kim, S.G.; Lee, Y.-H.; Lee, J.; Chang, H.-H.; Kim, S.-W.; Choi, J.-Y.; Cho, J.-H.; et al. Outcomes of COVID-19 among Patients on In-Center Hemodialysis: An Experience from the Epicenter in South Korea. J. Clin. Med. 2020, 9, 1688. https://doi.org/10.3390/jcm9061688
Jung H-Y, Lim J-H, Kang SH, Kim SG, Lee Y-H, Lee J, Chang H-H, Kim S-W, Choi J-Y, Cho J-H, et al. Outcomes of COVID-19 among Patients on In-Center Hemodialysis: An Experience from the Epicenter in South Korea. Journal of Clinical Medicine. 2020; 9(6):1688. https://doi.org/10.3390/jcm9061688
Chicago/Turabian StyleJung, Hee-Yeon, Jeong-Hoon Lim, Seok Hui Kang, Seong Gyu Kim, Yong-Hoon Lee, Jaehee Lee, Hyun-Ha Chang, Shin-Woo Kim, Ji-Young Choi, Jang-Hee Cho, and et al. 2020. "Outcomes of COVID-19 among Patients on In-Center Hemodialysis: An Experience from the Epicenter in South Korea" Journal of Clinical Medicine 9, no. 6: 1688. https://doi.org/10.3390/jcm9061688
APA StyleJung, H. -Y., Lim, J. -H., Kang, S. H., Kim, S. G., Lee, Y. -H., Lee, J., Chang, H. -H., Kim, S. -W., Choi, J. -Y., Cho, J. -H., Kim, C. -D., Kim, Y. -L., & Park, S. -H. (2020). Outcomes of COVID-19 among Patients on In-Center Hemodialysis: An Experience from the Epicenter in South Korea. Journal of Clinical Medicine, 9(6), 1688. https://doi.org/10.3390/jcm9061688