• Marian Goicoechea, Luis Alberto Sánchez Cámara, Nicolás Macías, Alejandra Muñoz de Morales, Ángela González Rojas, Arturo Bascuñana, David Arroyo, Almudena Vega, Soraya Abad, Eduardo Verde, Ana María García Prieto, Úrsula Verdalles, Diego Barbieri, Andrés Felipe Delgado, Javier Carbayo, Antonia Mijaylova, Adriana Acosta, Rosa Melero, Alberto Tejedor, Patrocinio Rodriguez Benitez, Ana Pérez de José, María Luisa Rodriguez Ferrero, Fernando Anaya, Manuel Rengel, Daniel Barraca, José Luño, and Inés Aragoncillo.
• Department of Nephrology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Red de Investigación Renal Instituto de Salud Carlos III (ISCIII) Red temática de investigación cooperativa en salud (RETIC) Red de Investigación Renal (REDINREN) RD016/009 (FEDER funds), Madrid, Spain. Electronic address: marian.goicoechea@gmail.com.
• Kidney Int. 2020 Jul 1; 98 (1): 27-34.

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia emerged in Wuhan, China in December 2019. Unfortunately, there is a lack of evidence about the optimal management of novel coronavirus disease 2019 (COVID-19), and even less is available in patients on maintenance hemodialysis therapy than in the general population. In this retrospective, observational, single-center study, we analyzed the clinical course and outcomes of all maintenance hemodialysis patients hospitalized with COVID-19 from March 12th to April 10th, 2020 as confirmed by real-time polymerase chain reaction. Baseline features, clinical course, laboratory data, and different therapies were compared between survivors and nonsurvivors to identify risk factors associated with mortality. Among the 36 patients, 11 (30.5%) died, and 7 were able to be discharged within the observation period. Clinical and radiological evolution during the first week of admission were predictive of mortality. Among the 36 patients, 18 had worsening of their clinical status, as defined by severe hypoxia with oxygen therapy requirements greater than 4 L/min and radiological worsening. Significantly, 11 of those 18 patients (61.1%) died. None of the classical cardiovascular risk factors in the general population were associated with higher mortality. Compared to survivors, nonsurvivors had significantly longer dialysis vintage, increased lactate dehydrogenase (490 U/l ± 120 U/l vs. 281 U/l ± 151 U/l, P = 0.008) and C-reactive protein levels (18.3 mg/dl ± 13.7 mg/dl vs. 8.1 mg/dl ± 8.1 mg/dl, P = 0.021), and a lower lymphocyte count (0.38 ×103/µl ± 0.14 ×103/µl vs. 0.76 ×103/µl ± 0.48 ×103/µl, P = 0.04) 1 week after clinical onset. Thus, the mortality among hospitalized hemodialysis patients diagnosed with COVID-19 is high. Certain laboratory tests can be used to predict a worsening clinical course.Copyright © 2020 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

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