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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

Risk factors associated with COVID-19 severity among patients on maintenance haemodialysis: a retrospective multicentre cross-sectional study in the UK Thumbnail


Authors

Haresh Selvaskandan

Katherine L. Hull

Sherna Adenwalla

Safa Ahmed

Maria-Cristina Cusu

Matthew Graham-Brown

Laura Gray

Matt Hall

Rizwan Hamer

Ammar Kanbar

Hemali Kanji

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.

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

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