Clinical Characteristics and Early Outcomes of Hospitalized COVID-19 Patients with End-Stage Kidney Disease in Saudi Arabia

Figures & data

Table 1 Demographic Characteristics and Co-Morbidities of COVID-19 Patients with End-Stage Kidney Disease

Variables	Overall (N=101)	Survived (N=81)	Deceased (N=20)	P
Age
21–45	32 (31.7%)	30 (37.0%)	2 (10.0%)	0.03*
46–64	31 (30.7%)	25 (30.9%)	6 (30.0%)
65–98	38 (37.6%)	26 (32.1%)	12 (60.0%)
Sex
Male	58 (57.4%)	44 (54.3%)	14 (70.0%)	0.20
Female	43 (42.6%)	37 (45.7%)	6 (30.0%)
Smoking
No	99 (98.0%)	80 (98.8%)	19 (95.0%)	0.28
Yes	2 (2.0%)	1 (1.2%)	1 (5.0%)
Diabetes
No	54 (53.5%)	50 (61.7%)	4 (20.0%)	0.001*
Yes	47 (46.5%)	31 (38.3%)	16 (80.0%)
Hypertension
No	12 (11.9%)	12 (14.8%)	0	0.01*
Yes	89 (88.1%)	69 (85.2%)	20 (100%)
Obesity
No	87 (86.1%)	70 (86.4%)	17 (85.0%)	0.87
Yes	14 (13.9%)	11 (13.6%)	3 (15.0%)
Heart disease
No	84 (83.2%)	71 (87.7%)	13 (65.0%)	0.01*
Yes	17 (16.8%)	10 (12.3%)	7 (35.0%)
Number of comorbidities
0	10 (9.9%)	10 (12.3%)	0	0.006*
1	35 (34.7%)	32 (39.5%)	3 (15.0%)
2	38 (37.6%)	29 (35.8%)	9 (45.0%)
≥ 3	18 (17.8%)	10 (12.3%)	8 (40.0%)
Co-infection
No	96 (95.0%)	80 (98.8%)	16 (80.0%)	0.001*
Yes	5 (5.0%)	1 (1.2%)	4 (20.0%)

Note: *Significant results (P value <0.05).

Table 2 Hemodialysis Type and Sessions That COVID-19 Patients with End-Stage Kidney Disease Received

Hemodialysis	Overall (N=101)	Survived (N=81)	Deceased (N=20)	P
Vintage in year	3.9 ± 3.8	3.9 ± 3.6	4.1 ± 4.9	0.485
Access
Arteriovenous fistula	64 (64%)	51 (63.8%)	13 (65%)	0.014*
Permcath	34 (34%)	29 (36.2%)	5 (25%)
Temporal line	2 (2%)	0	2 (10%)
Type
CRRT^^	84 (83.2%)	64 (79.0%)	20 (23.8%)	0.080
Conventional	16 (15.8%)	16 (19.8%)	0
Peritoneal	1 (1%)	1 (1.2%)	0
Sessions
Daily	13 (13.0%)	4 (5.0%)	9 (45%)	<0.001*
Two per week	68 (68.0%)	67 (83.8%)	1 (5%)
Three per week	19 (19.0%)	9 (11.2%)	10 (50%)
Anticoagulant
Heparin	53 (52.5%)	48 (59.3%)	5 (25%)	0.006*
Free heparin	48 (47.5%)	33 (40.7%)	15 (75%)

Notes: *Significant results (P value <0.05); ^ Continuous Renal Replacement Therapy.

Table 3 Clinical Symptoms and Signs on Admission Adjusted for Age, Sex and BMI

Symptoms & Signs	Overall (N=101)	Survived (N=81)	Deceased (N=20)	P
Difficulty breathing	41 (40.6%)	22 (27.2%)	19 (95.0%)	<0.001*
Cough	35 (34.7%)	26 (32.1%)	9 (45.0%)	0.28
Desaturation (SpO2 <94%)	21 (20.8%)	8 (9.9%)	13 (65.0%)	<0.001*
Fever	50 (49.5%)	36 (44.4%)	14 (70.0%)	0.04*
Confusion	13 (12.9%)	4 (4.9%)	9 (45.0%)	<0.001*
Diarrhea	10 (9.9%)	8 (9.9%)	2 (10.0%)	0.98
Temperature^^ (C°)^	36.8 ± 0.4	36.7 ± 0.4	36.8 ± 0.6	0.96
Systolic blood pressure (mmHg)^	140 ± 24.1	146 ± 22.0	128 ± 24.2	0.003*
Diastolic blood pressure (mmHg)^	74.5 ± 15.1	75 ± 15.9	70 ± 14.9	0.19
ICU admission	17 (16.8%)	1 (1.2%)	16 (80%)	<0.001*
Intubation	17 (16.8%)	1 (1.2%)	16 (80%)	<0.001*

Notes: *Significant results (P value <0.05); ^Independent-samples t-test and Mann–Whitney U-test compared means difference between groups according to the normality.

Figure 1 Kaplan–Meier survival analysis according to age groups.

Table 4 Clinical Laboratory Findings on Admission and 24-Hr Prior Recovery or Death Adjusted for Age, Sex and BMI

Variables	At Admission			24-Hr Prior to Recovery or Death
	Survived (N=81)	Deceased (N=20)	P	Survived (N=81)	Deceased (N=20)	P
Complete blood count
Hemoglobin (mmol/L)	10.6 ± 1.9	9.8 ± 1.3	0.025*	9.8 ± 0.43	8.9 ± 0.39	0.180
White blood cell (×10^9/L)	6.3 ± 0.4	9.1 ± 1.3	0.040*	8.6 ± 0.7	19.9 ± 3.6	0.003*
Platelets (×10^9/L)	209 ± 91.1	256 ± 119.2	0.050	257 ± 104.3	186 ± 108.2	0.040*
Neutrophils (%)	62 ± 14.7	76 ± 13.8	<0.001*	66.9 ± 3.2	86.6 ± 2.3	<0.001*
Lymphocytes (%)	24.6 ± 12.1	14.6 ± 10.0	0.001*	21.2 ± 2.8	6.9 ± 1.9	0.001*
Neutrophil/lymphocyte ratio	4.6 ± 0.8	12.5 ± 16.1	0.001*	6.6 ± 1.2	35.6 ± 10.8	<0.001*
Serum ferritin (pmol/L)	1522 ± 172	2566 ± 498	0.016*	1763 ± 282	4066 ± 1023	0.015*
Coagulation profile
D-dimer (mcg/mL)	1.6 ± 1.7	1.9 ± 1.8	0.511	2.9 ± 1.8	6.6 ± 3.8	0.028*
Prothrombin time (INR)	1.2 ± 0.1	1.2 ± 0.1	0.365	1.4 ± 0.2	1.7 ± 0.2	0.192
Electrolytes
Sodium (mmol/L)	136.3 ± 4.0	136.5 ± 4.4	0.911	134.1 ± 4.2	135.2 ± 5.2	0.423
Potassium (mmol/L)	4.8 ± 0.9	5.2 ± 1.3	0.139	4.8 ± 0.6	5.4 ± 1.5	0.069
Renal profile
Creatinine (μmol/L)	724 ± 30.1	785 ± 74.3	0.391	785 ± 78.9	658 ± 81.4	0.296
Blood urea nitrogen (mmol/L)	18.2 ± 7.7	26.0 ± 11.4	<0.001*	27.1 ± 12.0	34.8 ± 11.9	0.041*
Liver profile
Alanine aminotransferase (unit/L)	18.5 ± 1.8	26.7 ± 6.8	0.512	18.6 ± 4.6	95.3 ± 30.5	0.042*
Aspartate transaminase (unit/L)	22.3 ± 1.4	69.3 ± 22.2	0.001*	27.2 ± 5.8	135.3 ± 52.6	0.008*
Bilirubin (umol/L)	7.7 ± 6.1	7.6 ± 2.9	0.246	9.2 ± 5.5	16.3 ± 8.4	0.035*
Albumin (g/L)	36.5 ± 5.9	32.9 ± 7.9	0.037*	31.5 ± 6.0	29.4 ± 4.5	0.340

Note: *Significant results (P value <0.05).

Table 5 Predictors of Mortality and Intensive Care Unit (ICU) Admission in COVID-19 Patients

Predictors	ICU Admission			Mortality
	HR	95% CI	p-value	HR	95% CI	p-value
Age > 65 years	3.5	1.5–8.4	0.003*	2.6	1.3–5.1	0.008*
Sex	2.1	0.2–2.4	0.220	2.1	0.8–5.9	0.149
Smoking	2.4	0.3–5.8	0.451	1.9	0.1–4.3	0.552
Comorbidities
Obesity	1.1	0.9–1.2	0.439	1.8	0.5–6.3	0.382
Diabetes	2.5	0.7–9.8	0.285	1.9	0.6–6.3	0.249
Cardiovascular disease	1.7	0.5–6.2	0.427	3.6	1.3–10.1	0.016*
Laboratory investigations
Hemoglobin	1.3	0.8–2.3	0.237	1.1	0.84–1.4	0.503
White blood cell	1.4	0.9–2.2	0.093	1.6	1.3–2.4	0.064
Platelets	1.0	0.7–1.6	0.64	1.2	0.8–2.1	0.230
Neutrophils	1.7	0.9–3.1	0.110	2.9	1.4–6.3	0.004*
Lymphocytes	1.6	0.7–3.6	0.241	3.4	1.3–9.2	0.017*
SpO2 > 95%	2.3	0.2–3.1	0.042*	1.9	1.1–3.1	0.024*
D-dimer	2.2	0.8–5.3	0.013*	4.2	1.6–9.2	0.005*
Blood urea nitrogen	1.0	0.9–1.1	0.848	1.4	1.1–1.8	0.037*
Aspartate transaminase	1.1	0.9–1.2	0.081	1.1	1.0–1.8	0.033*
Associated complications
Respiratory failure/ARDS	3.9	1.3–6.9	0.032*	4.5	1.7–7.3	0.022*
Septic shock	1.9	0.7–2.9	0.089	2.3	0.9–4.2	0.064

Notes: *Comorbidities adjusted for one another + age, BMI and sex; Lab investigations were adjusted for age, BMI and Sex; Significant results (P value <0.05).