Skip to main content Skip to main navigation menu Skip to site footer

Clinical and laboratory comparison between End-Stage Kidney Disease patients with and without COVID-19: a cross-sectional study in a top referred hospital of West Nusa Tenggara

  • I Gede Yasa Asmara ,
  • I Gusti Ngurah Ommy Agustriadi ,
  • I Made Sujaya ,
  • Salim Said Thalib ,
  • Rina Lestari ,
  • Suryani Padua Fatrullah ,
  • Komang Sri Rahayu Widiasari ,
  • Indana Eva Ajmala ,
  • Metta Octora ,


Abstract

Background: The initial presentation of hospitalized End-Stage Kidney Disease (ESKD) patients with and without coronavirus disease 2019 (COVID-19) is similar and can overlap. We aimed to compare clinical dan laboratory characteristics of the COVID-19 positive and negative patients to help clinicians screen and differentiate hospitalized ESKD patients.

Methods: We reviewed data from the medical record of ESKD patients hospitalized between May 1, 2020, and April 30, 2021. The study comprised all suspected COVID-19 patients. The COVID-19 positive was based on results from RT-PCR for SARS-CoV-2. The bivariate analysis was used to compare the positive and negative groups. The association of all characteristics and diagnosis of COVID-19 were then evaluated by multivariable analysis.

Results: There was twenty-nine percent of confirmed COVID-19 in 176 ESKD patients. The proportion of dyspnea, pulmonary edema, pleural effusion, and cardiomegaly were lower in the COVID-19 positive group. Diastolic blood pressure, pulse rate, white blood cell differential counts, and potassium were lower in the COVID-19 positive group. Using a multivariate analysis, eosinophil count <0.04 x103µl (P<0.001, OR 3.50, 95%CI:0.123-0.665), monocyte count <0.69 x103µl (P=0.004, OR 2.54, 95%CI:0.166-0.931), and neutrophil-to-lymphocyte ratio (NLR) <3.13 (P=0.044, OR 3.18, 95%CI:0.102-0.968) were associated with the presence of COVID-19.

Conclusions: Leukocyte differential count and chest x-ray should be evaluated as an initial screening of COVID-19 in hospitalized ESKD. Low levels of monocyte and eosinophil count and mild elevation of NLR were associated with COVID-19 in ESKD patients.

Keywords: COVID-19 ESKD Eosinophil Monocyte NLR

References

  1. Farouk SS, Fiaccadori E, Cravedi P, Campbell KN. COVID-19 and the kidney: what we think we know so far and what we don’t. Journal of Nephrol. 2020;33(6):1213-8. https://doi.org/10.1007/s40620-020-00789-y
  2. Naicker S, Yang CW, Hwang SJ, Liu BC, Chen JH, Jha V. The Novel Coronavirus 2019 epidemic and kidneys. Kidney Int. 2020;97(5):824–8. https://doi.org/10.1016/j.kint.2020.03.001
  3. Stefan G, Mehedinti AM, Andreiana I, Zugravu AD, Cinca S, Busuioc R, et al. Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania. Ren Fail. 2021;43(1):49–57. https://doi.org/10.1080/0886022X.2020.1853571
  4. Kesehatan K. Pedoman Pencegahan dan Pengendalian Coronavirus Disease (COVID-19) Revisi ke-5. Kementrian Kesehatan. 2020. Accessed on: 22 Agustus 2021. Availabe at: https://covid19.go.id/storage/app/media/Protokol/2020/Juli/REV-05_Pedoman_P2_COVID-19_13_Juli_2020.pdf
  5. Sinha S, Swami R, Shakir A, Ali S, Bansode J, Mehta K. Clinical Profile and Outcome of Hemodialysis Patients with SARS COV2 Infection in a Tertiary Care Centre in Mumbai, India. Indian Journal of Nephrology. 2021;31(5):442-8. https://doi.org/10.4103/ijn.IJN_377_20
  6. Trujillo H, Caravaca-Fontán F, Sevillano Á, Gutiérrez E, Caro J, Gutiérrez E, et al. SARS-CoV-2 Infection in Hospitalized Patients With Kidney Disease. Kidney Int Rep. 2020;5(6):905–9. https://doi.org/10.1016/j.ekir.2020.04.024
  7. Valeri AM, Robbins-Juarez SY, Stevens JS, Ahn W, Rao MK, Radhakrishnan J, et al. Presentation and Outcomes of Patients with ESKD and COVID-19. J Am Soc Nephrol. 2020;31:1409–15. https://doi.org/10.1681/asn.2020040470
  8. Xiong F, Tang H, Liu L, Tu C, Tian JB, Lei CT, et al. Clinical Characteristics of and Medical Interventions for COVID-19 in Hemodialysis Patients in Wuhan, China. J Am Soc Nephrol. 2020;31(7):1387–98. https://doi.org/10.1681/ASN.2020030354
  9. Wu J, Li J, Zhu G, Zhang Y, Bi Z, Yu Y, et al. Clinical features of maintenance hemodialysis patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Clin J Am Soc Nephrol. 2020;15(8):1139–45. https://doi.org/10.2215/CJN.04160320
  10. PERNEFRI. Panduan Pencegahan Transmisi COVID-19 di Unit Dialisis. 2020. Accessed on: 12 December 2020. Available at: https://pernefri.org/acara/webinar%20All.pdf
  11. World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (‎‎‎‎‎‎2019-nCoV)‎‎‎‎‎‎ infection is suspected: interim guidance January 28, 2020. Accessed on: December12, 2020. Available at: https://www.who.int/publications/i/item/10665-332299
  12. Yau K, Muller MP, Lin M, Siddiqui N, Neskovic S, Shokar G, et al. COVID-19 Outbreak in an Urban Hemodialysis Unit. Am J Kidney Dis. 2020;76(5):690-5.e1. https://doi.org/10.1053/j.ajkd.2020.07.001
  13. Corbett RW, Blakey S, Nitsch D, Loucaidou M, McLean A, Duncan N, et al. Epidemiology of COVID-19 in an Urban Dialysis Center. J Am Soc Nephrol. 2020;31:1–9. https://doi.org/10.1681/ASN.2020040534
  14. Fisher M, Yunes M, Mokrzycki MH, Golestaneh L, Alahiri E, Coco M. Chronic Hemodialysis Patients Hospitalized with COVID-19: Short-term Outcomes in the Bronx, New York. Kidney360. 2020;1(8):755–62. https://doi.org/10.34067/kid.0003672020
  15. Huang R, Xie L, He J, Dong H, Liu T. Association between the peripheral blood eosinophil counts and covid-19 a meta-analysis. Medicine (Baltimore). 2021;100(23):e26047. https://doi.org/10.1097/MD.0000000000026047
  16. Xie G, Ding F, Han L, Yin D, Lu H, Zhang M. The role of peripheral blood eosinophil counts in COVID-19 patients. Allergy. 2021;76(2):471–82. https://doi.org/10.1111/all.14465
  17. Mu T, Yi Z, Wang M, Wang J, Zhang C, Chen H, et al. Expression of eosinophil in peripheral blood of patients with COVID-19 and its clinical significance. J Clin Lab Anal. 2021;35(1):e23620. https://doi.org/10.1002/jcla.23620
  18. Rajamanickam A, Kumar NP, Pandiarajan AN, Selvaraj N, Munisankar S, Renji RM, et al. Dynamic alterations in monocyte numbers, subset frequencies and activation markers in acute and convalescent COVID-19 individuals. Sci Rep. 2021;11(1):20254. https://doi.org/10.1038/s41598-021-99705-y
  19. Zahorec R, Hulin I, Zahorec P. Rationale Use of Neutrophil-to-lymphocyte ratio for early diagnosis and stratification of COVID-19. Bratisl Lek Listy. 2020;121(7):466–70. https://doi.org/10.4149/BLL
  20. Song CY, Xu J, He JQ, Lu YQ. COVID-19 early warning score: A multi-parameter screening tool to identify highly suspected patients. medRxiv. 2020. https://doi.org/10.1101/2020.03.05.20031906
  21. Alkhatip AAAMM, Kamel MG, Hamza MK, Farag EM, Yassin HM, Elayashy M, et al. The diagnostic and prognostic role of neutrophil-to-lymphocyte ratio in COVID-19: a systematic review and meta-analysis. Expert Rev Mol Diagn. 2021;21(5):505–14. https://doi.org/10.1080/14737159.2021.1915773
  22. Plantinga LC, King LM, Masud T, Shafi T, Burkart JM, Lea JP, et al. Burden and correlates of readmissions related to pulmonary edema in US hemodialysis patients: A cohort study. Nephrol Dial Transplant. 2018;33(7):1215–23. https://doi.org/10.1093/ndt/gfx335
  23. Zwaveling S, Gerth van Wijk R, Karim F. Pulmonary edema in COVID-19: Explained by bradykinin? J Allergy Clinical Immunol. 2020;146(6):1454–5. https://doi.org/10.1016/j.jaci.2020.08.038
  24. Rathore SS, Hussain N, Manju AH, Wen Q, Tousif S, Avendaño‐Capriles CA, et al. Prevalence and clinical outcomes of pleural effusion in COVID-19 patients: A systematic review and meta-analysis. J Med Virol. 2022;94(1):229–39. https://doi.org/10.1002/jmv.27301
  25. Sy S, Samaké M, Coulibaly M, Konaté M, Diallo D, Yattara H, et al. Prevalence of Cardiovascular Risk Factors in Chronic Hemodialysis Patients at the University Hospital Center of Point G in Bamako, Mali. Open J Nephrol. 2020;10(02):125–34. https://doi.org/10.4236/ojneph.2020.102013
  26. Mishra AK, Lal Aa, Sahu KK, Kranis M, Sargent J. Quantifying and reporting cardiac findings in imaging of COVID-19 patients. Monaldi Arch Chest Dis. 2020;90(4):627-32. https://doi.org/10.4081/MONALDI.2020.1394

How to Cite

Asmara, I. G. Y., Agustriadi, I. G. N. O., Sujaya, I. M., Thalib, S. S., Lestari, R., Fatrullah, S. P., Widiasari, K. S. R., Ajmala, I. E., & Octora, M. (2022). Clinical and laboratory comparison between End-Stage Kidney Disease patients with and without COVID-19: a cross-sectional study in a top referred hospital of West Nusa Tenggara. Bali Medical Journal, 11(3), 1074–1079. https://doi.org/10.15562/bmj.v11i3.3440
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
1

Total
0

Share

Search Panel

I Gede Yasa Asmara
Google Scholar
Pubmed
BMJ Journal

I Gusti Ngurah Ommy Agustriadi
Google Scholar
Pubmed
BMJ Journal

I Made Sujaya
Google Scholar
Pubmed
BMJ Journal

Salim Said Thalib
Google Scholar
Pubmed
BMJ Journal

Rina Lestari
Google Scholar
Pubmed
BMJ Journal

Suryani Padua Fatrullah
Google Scholar
Pubmed
BMJ Journal

Komang Sri Rahayu Widiasari
Google Scholar
Pubmed
BMJ Journal

Indana Eva Ajmala
Google Scholar
Pubmed
BMJ Journal

Metta Octora
Google Scholar
Pubmed
BMJ Journal