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

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.

EXPOSURE:

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.

• 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, Mark Lambie, Han Sean Lee, Khalid Mahdi, Rupert Major, James F Medcalf, Sushiladevi Natarajan, Boavojuvie Oseya, Stephanie Stringer, Matthew Tabinor, James Burton
• Journal: BMJ open (BMJ Open) Vol. 12 Issue 5 Pg. e054869 (05 30 2022) ISSN: 2044-6055 [Electronic] England
• PMID: 35636784 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Topics

• COVID-19 (epidemiology)
• Cross-Sectional Studies
• Diabetes Mellitus (epidemiology)
• Humans
• Obesity (epidemiology)
• Renal Dialysis
• Retrospective Studies
• Risk Factors
• SARS-CoV-2
• United Kingdom (epidemiology)