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Impact of first-wave COronaVIrus disease 2019 infection in patients on haemoDIALysis in Alsace: the observational COVIDIAL study.

Identifieur interne : 000501 ( Main/Exploration ); précédent : 000500; suivant : 000502

Impact of first-wave COronaVIrus disease 2019 infection in patients on haemoDIALysis in Alsace: the observational COVIDIAL study.

Auteurs : Nicolas Keller [France] ; François Chantrel [France] ; Thierry Krummel [France] ; Dorothée Bazin-Kara [France] ; Anne Laure Faller [France] ; Clotilde Muller [France] ; Thimothée Nussbaumer [France] ; Manfred Ismer [France] ; Abdellatif Benmoussa [France] ; Mohamed Brahim-Bouna [France] ; Stéphanie Beier [France] ; Peggy Perrin [France] ; Theirry Hannedouche [France]

Source :

RBID : pubmed:32871594

Descripteurs français

English descriptors

Abstract

BACKGROUND

There are only scarce data regarding the presentation, incidence, severity and outcomes of coronavirus disease 2019 (COVID-19) in patients undergoing long-term haemodialysis (HD). A prospective observational study was conducted in eight HD facilities in Alsace, France, to identify clinical characteristics of HD patients with COVID-19 and to assess the determinants of the risk of death.

METHODS

All HD patients tested positive for COVID-19 from 5 March to 28 April 2020 were included. Collected data included patient characteristics, clinical features at diagnosis, laboratory data, treatments and outcomes.

RESULTS

Among 1346 HD patients, 123 tested positive for COVID-19. Patients had a median age of 77 years (interquartile range 66-83), with a high number of comorbidities (3.2 ± 1.6 per patient). Symptoms were compatible in 63% of patients. Asthenia (77%), diarrhoea (34%) and anorexia (32%) were frequent at diagnosis. The delay between the onset of symptoms and diagnosis, death or complete recovery was 2 (0-5), 7 (4-11) and 32 (26.5-35) days, respectively. Treatment, including lopinavir/ritonavir, hydroxychloroquine and corticosteroids, was administered in 23% of patients. The median C-reactive protein (CRP) and lymphocyte count at diagnosis was 55 mg/L (IQR 25-106) and 690 Ly/µL (IQR 450-960), respectively. The case fatality rate was 24% and determinants associated with the risk of death were body temperature {hazard ratio [HR] 1.96 [95% confidence interval (CI) 1.11-3.44]; P = 0.02} and CRP at diagnosis [HR 1.01 (95% CI 1.005-1.017); P < 0.0001].

CONCLUSIONS

HD patients were found to be at high risk of developing COVID-19 and exhibited a high rate of mortality. While patients presented severe forms of the disease, they often displayed atypical symptoms, with the CRP level being highly associated with the risk of death.


DOI: 10.1093/ndt/gfaa170
PubMed: 32871594
PubMed Central: PMC7499735


Affiliations:


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Le document en format XML

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<name sortKey="Brahim Bouna, Mohamed" sort="Brahim Bouna, Mohamed" uniqKey="Brahim Bouna M" first="Mohamed" last="Brahim-Bouna">Mohamed Brahim-Bouna</name>
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<name sortKey="Beier, Stephanie" sort="Beier, Stephanie" uniqKey="Beier S" first="Stéphanie" last="Beier">Stéphanie Beier</name>
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<name sortKey="Perrin, Peggy" sort="Perrin, Peggy" uniqKey="Perrin P" first="Peggy" last="Perrin">Peggy Perrin</name>
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<name sortKey="Keller, Nicolas" sort="Keller, Nicolas" uniqKey="Keller N" first="Nicolas" last="Keller">Nicolas Keller</name>
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<name sortKey="Chantrel, Francois" sort="Chantrel, Francois" uniqKey="Chantrel F" first="François" last="Chantrel">François Chantrel</name>
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<name sortKey="Bazin Kara, Dorothee" sort="Bazin Kara, Dorothee" uniqKey="Bazin Kara D" first="Dorothée" last="Bazin-Kara">Dorothée Bazin-Kara</name>
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<name sortKey="Ismer, Manfred" sort="Ismer, Manfred" uniqKey="Ismer M" first="Manfred" last="Ismer">Manfred Ismer</name>
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<country xml:lang="fr">France</country>
<wicri:regionArea>AURAL Association Dialysis centre, Colmar</wicri:regionArea>
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<region type="region">Grand Est</region>
<region type="old region">Alsace (région administrative)</region>
<settlement type="city">Colmar</settlement>
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<name sortKey="Benmoussa, Abdellatif" sort="Benmoussa, Abdellatif" uniqKey="Benmoussa A" first="Abdellatif" last="Benmoussa">Abdellatif Benmoussa</name>
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<region type="region">Grand Est</region>
<region type="old region">Alsace (région administrative)</region>
<settlement type="city">Mulhouse</settlement>
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<name sortKey="Brahim Bouna, Mohamed" sort="Brahim Bouna, Mohamed" uniqKey="Brahim Bouna M" first="Mohamed" last="Brahim-Bouna">Mohamed Brahim-Bouna</name>
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<nlm:affiliation>DIAVERUM Dialysis Centre, Mulhouse, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>DIAVERUM Dialysis Centre, Mulhouse</wicri:regionArea>
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<region type="region">Grand Est</region>
<region type="old region">Alsace (région administrative)</region>
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<name sortKey="Beier, Stephanie" sort="Beier, Stephanie" uniqKey="Beier S" first="Stéphanie" last="Beier">Stéphanie Beier</name>
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<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Betacoronavirus (genetics)</term>
<term>Biomarkers (blood)</term>
<term>C-Reactive Protein (metabolism)</term>
<term>Comorbidity (MeSH)</term>
<term>Coronavirus Infections (blood)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>DNA, Viral (analysis)</term>
<term>Female (MeSH)</term>
<term>France (epidemiology)</term>
<term>Humans (MeSH)</term>
<term>Kidney Failure, Chronic (blood)</term>
<term>Kidney Failure, Chronic (epidemiology)</term>
<term>Kidney Failure, Chronic (therapy)</term>
<term>Male (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (blood)</term>
<term>Pneumonia, Viral (epidemiology)</term>
<term>Prospective Studies (MeSH)</term>
<term>Renal Dialysis (methods)</term>
<term>Survival Rate (trends)</term>
</keywords>
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<term>ADN viral (analyse)</term>
<term>Betacoronavirus (génétique)</term>
<term>Comorbidité (MeSH)</term>
<term>Dialyse rénale (méthodes)</term>
<term>Défaillance rénale chronique (sang)</term>
<term>Défaillance rénale chronique (thérapie)</term>
<term>Défaillance rénale chronique (épidémiologie)</term>
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<term>France (épidémiologie)</term>
<term>Humains (MeSH)</term>
<term>Infections à coronavirus (sang)</term>
<term>Infections à coronavirus (épidémiologie)</term>
<term>Marqueurs biologiques (sang)</term>
<term>Mâle (MeSH)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (sang)</term>
<term>Pneumopathie virale (épidémiologie)</term>
<term>Protéine C-réactive (métabolisme)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Taux de survie (tendances)</term>
<term>Études prospectives (MeSH)</term>
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<term>Pneumonia, Viral</term>
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<term>Kidney Failure, Chronic</term>
<term>Pneumonia, Viral</term>
</keywords>
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<term>Betacoronavirus</term>
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<term>Betacoronavirus</term>
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<term>C-Reactive Protein</term>
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<term>Renal Dialysis</term>
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<term>Protéine C-réactive</term>
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<term>Marqueurs biologiques</term>
<term>Pneumopathie virale</term>
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<term>Taux de survie</term>
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<term>Kidney Failure, Chronic</term>
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<term>Défaillance rénale chronique</term>
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<term>Survival Rate</term>
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<term>France</term>
<term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
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<term>Aged, 80 and over</term>
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<term>Humains</term>
<term>Mâle</term>
<term>Pandémies</term>
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<div type="abstract" xml:lang="en">
<p>
<b>BACKGROUND</b>
</p>
<p>There are only scarce data regarding the presentation, incidence, severity and outcomes of coronavirus disease 2019 (COVID-19) in patients undergoing long-term haemodialysis (HD). A prospective observational study was conducted in eight HD facilities in Alsace, France, to identify clinical characteristics of HD patients with COVID-19 and to assess the determinants of the risk of death.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>All HD patients tested positive for COVID-19 from 5 March to 28 April 2020 were included. Collected data included patient characteristics, clinical features at diagnosis, laboratory data, treatments and outcomes.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>Among 1346 HD patients, 123 tested positive for COVID-19. Patients had a median age of 77 years (interquartile range 66-83), with a high number of comorbidities (3.2 ± 1.6 per patient). Symptoms were compatible in 63% of patients. Asthenia (77%), diarrhoea (34%) and anorexia (32%) were frequent at diagnosis. The delay between the onset of symptoms and diagnosis, death or complete recovery was 2 (0-5), 7 (4-11) and 32 (26.5-35) days, respectively. Treatment, including lopinavir/ritonavir, hydroxychloroquine and corticosteroids, was administered in 23% of patients. The median C-reactive protein (CRP) and lymphocyte count at diagnosis was 55 mg/L (IQR 25-106) and 690 Ly/µL (IQR 450-960), respectively. The case fatality rate was 24% and determinants associated with the risk of death were body temperature {hazard ratio [HR] 1.96 [95% confidence interval (CI) 1.11-3.44]; P = 0.02} and CRP at diagnosis [HR 1.01 (95% CI 1.005-1.017); P < 0.0001].</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSIONS</b>
</p>
<p>HD patients were found to be at high risk of developing COVID-19 and exhibited a high rate of mortality. While patients presented severe forms of the disease, they often displayed atypical symptoms, with the CRP level being highly associated with the risk of death.</p>
</div>
</front>
</TEI>
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<Year>2020</Year>
<Month>09</Month>
<Day>15</Day>
</DateCompleted>
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<Year>2020</Year>
<Month>09</Month>
<Day>22</Day>
</DateRevised>
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<Journal>
<ISSN IssnType="Electronic">1460-2385</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>35</Volume>
<Issue>8</Issue>
<PubDate>
<Year>2020</Year>
<Month>08</Month>
<Day>01</Day>
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<Title>Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association</Title>
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<AbstractText Label="BACKGROUND">There are only scarce data regarding the presentation, incidence, severity and outcomes of coronavirus disease 2019 (COVID-19) in patients undergoing long-term haemodialysis (HD). A prospective observational study was conducted in eight HD facilities in Alsace, France, to identify clinical characteristics of HD patients with COVID-19 and to assess the determinants of the risk of death.</AbstractText>
<AbstractText Label="METHODS">All HD patients tested positive for COVID-19 from 5 March to 28 April 2020 were included. Collected data included patient characteristics, clinical features at diagnosis, laboratory data, treatments and outcomes.</AbstractText>
<AbstractText Label="RESULTS">Among 1346 HD patients, 123 tested positive for COVID-19. Patients had a median age of 77 years (interquartile range 66-83), with a high number of comorbidities (3.2 ± 1.6 per patient). Symptoms were compatible in 63% of patients. Asthenia (77%), diarrhoea (34%) and anorexia (32%) were frequent at diagnosis. The delay between the onset of symptoms and diagnosis, death or complete recovery was 2 (0-5), 7 (4-11) and 32 (26.5-35) days, respectively. Treatment, including lopinavir/ritonavir, hydroxychloroquine and corticosteroids, was administered in 23% of patients. The median C-reactive protein (CRP) and lymphocyte count at diagnosis was 55 mg/L (IQR 25-106) and 690 Ly/µL (IQR 450-960), respectively. The case fatality rate was 24% and determinants associated with the risk of death were body temperature {hazard ratio [HR] 1.96 [95% confidence interval (CI) 1.11-3.44]; P = 0.02} and CRP at diagnosis [HR 1.01 (95% CI 1.005-1.017); P < 0.0001].</AbstractText>
<AbstractText Label="CONCLUSIONS">HD patients were found to be at high risk of developing COVID-19 and exhibited a high rate of mortality. While patients presented severe forms of the disease, they often displayed atypical symptoms, with the CRP level being highly associated with the risk of death.</AbstractText>
<CopyrightInformation>© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.</CopyrightInformation>
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<li>Alsace (région administrative)</li>
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<name sortKey="Perrin, Peggy" sort="Perrin, Peggy" uniqKey="Perrin P" first="Peggy" last="Perrin">Peggy Perrin</name>
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