Details

Autor(en) / Beteiligte

• Cidraque, Ignacio
• Román, Vicente García
• Pérez, Alicia Sobrino
• Bello, Abraham Rincon
• Shkolenko, Kateryna
• Ortego, Sofia
• Blanco, Ana
• Samaniego, Diana
• Salvador, Maria Eva Baró

Titel

4654 THROMBOEMBOLIC EVENTS AND THEIR RELATIONSHIP WITH COVID-19 IN HEMODIALYSIS PATIENTS: MYTH OR TRUE ?

Ist Teil von

• Nephrology, dialysis, transplantation, 2023-06, Vol.38 (Supplement_1)

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Background and Aims Since the beginning of COVID-19 pandemic, there has been more than 668 million of diagnosis and more than 6 million deaths worldwide. This pandemic also has had a dramatic impact on chronic patients, such as those with end stage renal disease (ESRD) on hemodialysis (HD). Many studies have hypothesized that COVID-19 could induce a hypercoagulability state, activating coagulation cascade. Post-mortem studies revealed vascular injuries in more than 60% of lung tissues and many patients diagnosed with COVID-19 have suffered neurological pathologies, as ischemic stroke. Patients with ESRD are also at higher risk of thromboembolic events than healthy subjects. In this study, we analyze thromboembolic events in HD patients with or without COVID-19 diagnosis. Method We performed a retrospective observational study between March 2020 and December 2022 with 4679 HD patients (2635 COVID-19 positive patients (Group 1) and 2044 COVID-19 negative (Group 2)) from 50 Spanish clinics. The baseline dates of the non COVID-19 patients were randomly chosen. Follow-up time was 1 year since COVID-19 diagnosis (Group 1) or since selection (Group 2). We identified patients who has suffered any thromboembolic event during follow-up time. We compared usual clinical parameters between groups using Chi2 and Mann-Whitney U tests. Survival analysis was performed by Kaplan-Meier and Cox regression. Continuous variables were categorized to perform the Cox analysis. Results Small differences between Group 1 and 2 were found in age (70.45 (62-81) vs 68.94 (61-80); p<0.001), proportion of men (63% vs 67.2%; p<0.05), HD vintage (34 (14-71) vs 30 (11-65); p<0.05), preHD systolic blood pressure (SBP) (140.73 (126-155) vs 142.65 (128-157); p<0.05), plasma hemoglobin (Hb) (11.19 (10.40-11.90) vs 11.31 (10.5-12); p<0.05) and proportion of patients with antithrombic medication (604 (22.9%) vs 401 (19.6%); p<0.05). No statistically significant differences were found in time to first thromboembolic event between the two groups (Figure 1). In univariate Cox regression (Table 1) thromboembolic events showed significant relation with gender, Charlson Index above 8, preHD relative overhydration (relOH) above 13.4% and preHD SBP above 155 mmHg. In multivariate analysis (Table 1), Charlson Index and preHD SBP showed hazard ratio above 1.5 for thromboembolic event (p<0.05). COVID-19 diagnosis did not show relationship with thromboembolic events. Conclusion Publications on thromboembolic events in HD patients who have suffered from COVID-19 are scarce and with small size samples. In our large HD sample, thromboembolic events were not related to COVID-19. Only Charlson Index and preHD SBP showed a significant relationship in the multivariate analysis.