Survival and predictive factors in dialysis patients with COVID-19 in Japan: a nationwide cohort study

Kan Kikuchi,Ken Sakai,Munekazu Ryuzaki,Toshio Shinoda,Masaomi Nangaku,Oota Yoshihiro,Norio Hanafusa,Hidetomo Nakamoto,Yoshihiko Kanno,Ryoichi Ando,Tomoyuki Yamakawa,Tadao Akizawa

doi:10.1186/s41100-021-00378-0

Abstract

BackgroundThe Japanese Association of Dialysis Physicians, the Japanese Society for Dialysis Therapy, and the Japanese Society of Nephrology jointly established COVID-19 Task Force Committee and began surveying the number of newly infected patients.MethodsThis registry of the COVID-19 Task Force Committee was used to collect data of dialysis patients; a total of 1010 dialysis patients with COVID-19 were included in the analysis. Overall survival of patients was investigated with stratification by age group, complication status, and treatment. In addition, predictive factors for mortality were also investigated. The overall survival was estimated by Kaplan–Meier methods and compared by using log-rank test. Multivariate analysis was performed to identify the risk factor of mortality. For all statistical analyses, p < 0.05 was considered to be statistically significant.ResultsThe mortality risk was increased with age (p < 0.001). The mortality risk was significantly higher in patients with peripheral arterial disease (HR: 1.49, 95% CI 1.05–2.10) and significantly lower in patients who were treated with remdesivir (HR: 0.60, 95% CI 0.37–0.98). Multivariate analysis showed increased risk of mortality with increment in BMI, and increment in CRP, and decreased risk with increment in albumin.ConclusionDialysis patients have a high severity of illness and a high risk of mortality in cases of COVID-19. Treatment with remdesivir might be effective in shortening the duration of hospitalization and reducing the risk of mortality.

Highlights

The Japanese Association of Dialysis Physicians, the Japanese Society for Dialysis Therapy, and the Japanese Society of Nephrology jointly established COVID-19 Task Force Committee and began surveying the number of newly infected patients
The mortality risk was significantly higher in patients with peripheral arterial disease (HR: 1.49, 95% CI 1.05–2.10) in terms of complication and was significantly lower in patients who were treated with remdesivir (HR: 0.60, 95% CI 0.37–0.98) in terms of treatment for COVID-19 (Table 3)
Our study showed that the mortality rate among dialysis patients in Japan was high at 30.8%, which was 20 times higher than the mortality rate of 1.5% in the general population for the same period, June 16, 2021 [5]

Summary

Introduction

The Japanese Association of Dialysis Physicians, the Japanese Society for Dialysis Therapy, and the Japanese Society of Nephrology jointly established COVID-19 Task Force Committee and began surveying the number of newly infected patients. The Japanese Association of Dialysis Physicians, the Japanese Society for Dialysis Therapy, and the Japanese Society of Nephrology jointly established COVID-19 Task Force Committee to survey the number of newly infected patients and create guidance on preventive measures for COVID-19 for raising awareness [3]. The fifth wave began in Japan in July 2021, and a rapid increase in the number of newly infected dialysis patients was observed, with a cumulative total of 2156 infected dialysis patients as of August 12, 2021 [4]

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