TY  - JOUR
A1  - Pilgram, Lisa
A1  - Eberwein, Lukas
A1  - Wille, Kai
A1  - Koehler, Felix C.
A1  - Stecher, Melanie
A1  - Rieg, Siegbert
A1  - Kielstein, Jan T.
A1  - Jakob, Carolin E. M.
A1  - Rüthrich, Maria
A1  - Burst, Volker
A1  - Prasser, Fabian
A1  - Borgmann, Stefan
A1  - Müller, Roman-Ulrich
A1  - Lanznaster, Julia
A1  - Isberner, Nora
A1  - Tometten, Lukas
A1  - Dolff, Sebastian
T1  - Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease
JF  - Infection
N2  - Purpose
The ongoing pandemic caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2) has stressed health systems worldwide. Patients with chronic kidney disease (CKD) seem to be more prone to a severe course of coronavirus disease (COVID-19) due to comorbidities and an altered immune system. The study’s aim was to identify factors predicting mortality among SARS-CoV-2-infected patients with CKD.

Methods
We analyzed 2817 SARS-CoV-2-infected patients enrolled in the Lean European Open Survey on SARS-CoV-2-infected patients and identified 426 patients with pre-existing CKD. Group comparisons were performed via Chi-squared test. Using univariate and multivariable logistic regression, predictive factors for mortality were identified.

Results
Comparative analyses to patients without CKD revealed a higher mortality (140/426, 32.9% versus 354/2391, 14.8%). Higher age could be confirmed as a demographic predictor for mortality in CKD patients (> 85 years compared to 15–65 years, adjusted odds ratio (aOR) 6.49, 95% CI 1.27–33.20, p = 0.025). We further identified markedly elevated lactate dehydrogenase (> 2 × upper limit of normal, aOR 23.21, 95% CI 3.66–147.11, p < 0.001), thrombocytopenia (< 120,000/µl, aOR 11.66, 95% CI 2.49–54.70, p = 0.002), anemia (Hb < 10 g/dl, aOR 3.21, 95% CI 1.17–8.82, p = 0.024), and C-reactive protein (≥ 30 mg/l, aOR 3.44, 95% CI 1.13–10.45, p = 0.029) as predictors, while renal replacement therapy was not related to mortality (aOR 1.15, 95% CI 0.68–1.93, p = 0.611).

Conclusion
The identified predictors include routinely measured and universally available parameters. Their assessment might facilitate risk stratification in this highly vulnerable cohort as early as at initial medical evaluation for SARS-CoV-2.
KW  - chronic kidney disease
KW  - COVID-19
KW  - LEOSS
KW  - predictive factor
KW  - SARS-CoV-2
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-308957
SN  - 0300-8126
SN  - 1439-0973
VL  - 49
IS  - 4
ER  - 
TY  - JOUR
A1  - Meintrup, David
A1  - Borgmann, Stefan
A1  - Seidl, Karlheinz
A1  - Stecher, Melanie
A1  - Jakob, Carolin E. M.
A1  - Pilgram, Lisa
A1  - Spinner, Christoph D.
A1  - Rieg, Siegbert
A1  - Isberner, Nora
A1  - Hower, Martin
A1  - Vehreschild, Maria
A1  - Göpel, Siri
A1  - Hanses, Frank
A1  - Nowak-Machen, Martina
T1  - Specific risk factors for fatal outcome in critically ill COVID-19 patients: results from a European multicenter study
JF  - Journal of Clinical Medicine
N2  - (1) Background: The aim of our study was to identify specific risk factors for fatal outcome in critically ill COVID-19 patients. (2) Methods: Our data set consisted of 840 patients enclosed in the LEOSS registry. Using lasso regression for variable selection, a multifactorial logistic regression model was fitted to the response variable survival. Specific risk factors and their odds ratios were derived. A nomogram was developed as a graphical representation of the model. (3) Results: 14 variables were identified as independent factors contributing to the risk of death for critically ill COVID-19 patients: age (OR 1.08, CI 1.06–1.10), cardiovascular disease (OR 1.64, CI 1.06–2.55), pulmonary disease (OR 1.87, CI 1.16–3.03), baseline Statin treatment (0.54, CI 0.33–0.87), oxygen saturation (unit = 1%, OR 0.94, CI 0.92–0.96), leukocytes (unit 1000/μL, OR 1.04, CI 1.01–1.07), lymphocytes (unit 100/μL, OR 0.96, CI 0.94–0.99), platelets (unit 100,000/μL, OR 0.70, CI 0.62–0.80), procalcitonin (unit ng/mL, OR 1.11, CI 1.05–1.18), kidney failure (OR 1.68, CI 1.05–2.70), congestive heart failure (OR 2.62, CI 1.11–6.21), severe liver failure (OR 4.93, CI 1.94–12.52), and a quick SOFA score of 3 (OR 1.78, CI 1.14–2.78). The nomogram graphically displays the importance of these 14 factors for mortality. (4) Conclusions: There are risk factors that are specific to the subpopulation of critically ill COVID-19 patients.
KW  - COVID-19
KW  - SARS-CoV-2
KW  - risk factors
KW  - critically ill patients
KW  - comorbidities
KW  - lasso regression
KW  - nomogram
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-245191
SN  - 2077-0383
VL  - 10
IS  - 17
ER  -