A new scoring system for Covid-19 in patients on hemodialysis: Modified Early Warning score

Radojica Stolić Orcid logo ,
Radojica Stolić
Dragica Bukumirić ,
Dragica Bukumirić
Milena Jovanović ,
Milena Jovanović
Tomislav Nikolić ,
Tomislav Nikolić
Tatjana Labudović ,
Tatjana Labudović
Vekoslav Mitrović ,
Vekoslav Mitrović
Kristina Bulatović ,
Kristina Bulatović
Saša Sovtić ,
Saša Sovtić
Dušica Miljković ,
Dušica Miljković
Aleksandra Balović ,
Aleksandra Balović
Roksanda Krivcević ,
Roksanda Krivcević
Sanja Jovanović
Sanja Jovanović

Published: 01.12.2020.

Volume 50, Issue 1 (2021)

pp. 1-6;

https://doi.org/10.5937/pramed2102001s

Abstract

Introduction. At the very beginning of the Corona virus epidemic there was not enough data on whether hemodialysis patients have a higher risk for Corona virus infection and which factors may affect the severity of clinical picture. Objective. The aim of the study was to determine the significance of the Modified Early Warning Assessment (MEWS) score for the assessment of coronavirus disease exacerbation. Methods. The research was conducted in COVID dialysis, as a retrospective, descriptive-analytical study, at the University Clinical Center Kragujevac, Serbia, which was organized ad-hoc for treatment of SARS-Cov-2 infection positive patients, which are transfered from Center for Hemodialysis "Ćuprija". They were evaluated routine laboratory findings, demographic and gender structure, arterial blood pressure, presence of comorbidities and residual diuresis, duration of dialysis, radiological evaluation of lungs, determination of MEWS score were the parameters that were monitored. The results were monitored on admission and and in the end of treatment. Results. A statistically significant difference was registered in serum lactate dehydrogenase concentration (486 ± 107.62 vs. 423.7 ± 92.4 U/L); p = 0.022 and absolute monocyte count (0.46 ± 0.15 vs. 0.67 ± 0.34 x 103; p = 0.008). The significant increase in MEWS score was also found (b = 0.017; p = 0.030). There was a positive correlation between increase of MEWS score and age (b = 0.027; p = 0.002) and arterial hypertension as a concomitant comorbidity (b = 0.700; p = 0.033). Conclusion. In the observed period, there was a significant increase in the degree of MEWS score of dialysis patients who had SARS-Cov-2 infection.

References

1.
Naicker S, Yang CW, Hwang SJ, Liu BC, Chen JH, Jha V. The Novel Coronavirus 2019 epidemic and kidneys. Vol. 97, Kidney International. 2020. p. 824–8.
2.
Wang R, Liao C, He H, Hu C, Wei Z, Hong Z, et al. COVID-19 in Hemodialysis Patients: A Report of 5 Cases. Vol. 76, American Journal of Kidney Diseases. 2020. p. 141–3.
3.
Kliger AS, Silberzweig J. Mitigating Risk of COVID-19 in Dialysis Facilities. Vol. 15, Clinical Journal of the American Society of Nephrology. 2020. p. 707–9.
4.
Brekke IJ, Puntervoll LH, Pedersen PB, Kellett J, Brabrand M. The value of vital sign trends in predicting and monitoring clinical deterioration: A systematic review. Vol. 14, PLOS ONE. p. e0210875.
5.
Subbe CP. Validation of a modified Early Warning Score in medical admissions. Vol. 94, QJM. 2001. p. 521–6.
6.
Li J, Xu G. Lessons from the Experience in Wuhan to Reduce Risk of COVID-19 Infection in Patients Undergoing Long-Term Hemodialysis. Vol. 15, Clinical Journal of the American Society of Nephrology. 2020. p. 717–9.
7.
Ikizler TA, Kliger AS. Minimizing the risk of COVID-19 among patients on dialysis. Vol. 16, Nature Reviews Nephrology. 2020. p. 311–3.
8.
Tang B, Li S, Xiong Y, Tian M, Yu J, Xu L, et al. COVID-19 Pneumonia in a Hemodialysis Patient. Vol. 2, Kidney Medicine. 2020. p. 354–8.
9.
Chiu S, Bharat A. Role of monocytes and macrophages in regulating immune response following lung transplantation. Vol. 21, Current Opinion in Organ Transplantation. 2016. p. 239–45.
10.
Kermali M, Khalsa RK, Pillai K, Ismail Z, Harky A. The role of biomarkers in diagnosis of COVID-19 – A systematic review. Vol. 254, Life Sciences. 2020. p. 117788.
11.
Goicoechea M, Sánchez Cámara LA, Macías N, Muñoz de Morales A, Rojas ÁG, Bascuñana A, et al. COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Vol. 98, Kidney International. 2020. p. 27–34.
12.
Ronco C, Reis T. Kidney involvement in COVID-19 and rationale for extracorporeal therapies. Vol. 16, Nature Reviews Nephrology. 2020. p. 308–10.
13.
Ferrey AJ, Choi G, Hanna RM, Chang Y, Tantisattamo E, Ivaturi K, et al. A Case of Novel Coronavirus Disease 19 in a Chronic Hemodialysis Patient Presenting with Gastroenteritis and Developing Severe Pulmonary Disease. Vol. 51, American Journal of Nephrology. 2020. p. 337–42.
14.
Mali SN, Thorat BR, Chopade AR. A Viewpoint on Angiotensin-Converting Enzyme 2, Anti-Hypertensives and Coronavirus Disease 2019 (COVID-19). Vol. 21, Infectious Disorders - Drug Targets. 2021. p. 311–3.
15.
Schmidt RJ, Landry DL, Cohen L, Moss AH, Dalton C, Nathanson BH, et al. Derivation and validation of a prognostic model to predict mortality in patients with advanced chronic kidney disease. Vol. 34, Nephrology Dialysis Transplantation. 2019. p. 1517–25.

Citation

Copyright

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Most read articles

Indexed by