Haresh Selvaskandan
Risk factors associated with COVID-19 severity among patients on maintenance haemodialysis: a retrospective multicentre cross-sectional study in the UK
Selvaskandan, Haresh; Hull, Katherine L.; Adenwalla, Sherna; Ahmed, Safa; Cusu, Maria-Cristina; Graham-Brown, Matthew; Gray, Laura; Hall, Matt; Hamer, Rizwan; Kanbar, Ammar; Kanji, Hemali; Lambie, Mark; Lee, Han Sean; Mahdi, Khalid; Major, Rupert; Medcalf, James F.; Natarajan, Sushiladevi; Oseya, Boavojuvie; Stringer, Stephanie; Tabinor, Matthew; Burton, James
Authors
Katherine L. Hull
Sherna Adenwalla
Safa Ahmed
Maria-Cristina Cusu
Matthew Graham-Brown
Laura Gray
Matt Hall
Rizwan Hamer
Ammar Kanbar
Hemali Kanji
Mark Lambie m.lambie@keele.ac.uk
Han Sean Lee
Khalid Mahdi
Rupert Major
James F. Medcalf
Sushiladevi Natarajan
Boavojuvie Oseya
Stephanie Stringer
Matthew Tabinor
James Burton
Abstract
Objectives To assess the applicability of risk factors for severe COVID-19 defined in the general population for patients on haemodialysis.
Setting A retrospective cross-sectional study performed across thirty four haemodialysis units in midlands of the UK.
Participants All 274 patients on maintenance haemodialysis who tested positive for SARS-CoV-2 on PCR testing between March and August 2020, in participating haemodialysis centres.
Exposur: The utility of obesity, diabetes status, ethnicity, Charlson Comorbidity Index (CCI) and socioeconomic deprivation scores were investigated as risk factors for severe COVID-19.
Main outcomes and measures Severe COVID-19, defined as requiring supplemental oxygen or respiratory support, or a C reactive protein of =75?mg/dL (RECOVERY trial definitions), and its association with obesity, diabetes status, ethnicity, CCI, and socioeconomic deprivation.
Results 63.5% (174/274 patients) developed severe disease. Socioeconomic deprivation associated with severity, being most pronounced between the most and least deprived quartiles (OR 2.81, 95%?CI 1.22 to 6.47, p=0.015), after adjusting for age, sex and ethnicity. There was no association between obesity, diabetes status, ethnicity or CCI with COVID-19 severity. We found no evidence of temporal evolution of cases (p=0.209) or clustering that would impact our findings.
Conclusion The incidence of severe COVID-19 is high among patients on haemodialysis; this cohort should be considered high risk. There was strong evidence of an association between socioeconomic deprivation and COVID-19 severity. Other risk factors that apply to the general population may not apply to this cohort.
Citation
Selvaskandan, H., Hull, K. L., Adenwalla, S., Ahmed, S., Cusu, M., Graham-Brown, M., …Burton, J. (2022). Risk factors associated with COVID-19 severity among patients on maintenance haemodialysis: a retrospective multicentre cross-sectional study in the UK. BMJ Open, 12(5), Article ARTN e054869. https://doi.org/10.1136/bmjopen-2021-054869
Journal Article Type | Article |
---|---|
Acceptance Date | Apr 28, 2022 |
Publication Date | May 30, 2022 |
Journal | BMJ Open |
Publisher | BMJ Publishing Group |
Volume | 12 |
Issue | 5 |
Article Number | ARTN e054869 |
DOI | https://doi.org/10.1136/bmjopen-2021-054869 |
Keywords | COVID-19; dialysis; epidemiology |
Publisher URL | https://bmjopen.bmj.com/content/12/5/e054869.info |
Files
e054869.full (1).pdf
(12.8 Mb)
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Publisher Licence URL
https://creativecommons.org/licenses/by/4.0/
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