MO870 <br/>HYPOCHLOREMIA IS ASSOCIATED WITH A GREATER INCIDENCE OF PNEUMONIA IN CHRONIC HEMODIALYSIS PATIENTS WITH COVID-19: A CENTER'S EXPERIENCE

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Abstract

Background and Aims

Recently, serum chloride has gained greater importance in the assessment of patients with heart failure and sepsis. Hypochloremia has been associated with higher mortality. On the other hand, COVID-19 pandemic continues to be, to date, a threat to public health. Patients with cardiovascular comorbidity or chronic kidney disease are particularly vulnerable. There are some studies that show a trend towards a lower serum chloride concentration in patients with a positive PCR test for SARS-CoV-2. Therefore, the objective of our study was to determine if there is a relationship between serum chloride levels at the time of diagnosis and a greater tendency to develop COVID-19 pneumonia in chronic hemodialysis patients.

Method

Retrospective cohort study. We analyzed the serum chloride, C-reactive protein (CRP), procalcitonin, neutrophil-lymphocyte (NLR) and platelet-lymphocyte (PLR) ratios of 11 chronic hemodialysis patients with a positive SARS-CoV-2 TMA PCR test during the second wave of the pandemic in our hospital (August-December 2020). We collected the length of hospital stay, the diagnosis of pneumonia (yes/no) and the final state of the infection (cure or death). The patients were divided into two groups taking the median serum chloride as the cut-off point (1: <97 mEq / L and 2:> 97mEq / L)

Results

The mean age was 57 ± 13 years and 36.36% (N = 4) were women. All patients required hospital admission and mean hospitalization time was 19 ± 13 days. 3 patients (27.3%) died. The medians of the parameters were the following: serum chloride 97 mEq / L (IQR 94-99); CRP 29.04 mg / L (IQR 8.53-76.13); NLR 4.13 (IQR 2.67-8.48) and PLR 244.06 (IQR 208.08-320). 81.8% (N = 9) had COVID-19 pneumonia. Group 1 patients (Chloride <97 mEL / L) had a higher incidence of pneumonia (p = 0.049) ( Figure 1 ) and a greater tendency to be admitted to the Intensive Care Unit (ICU) (p = 0.029). Despite not reaching statistical significance, there was also a higher mortality in patients with lower chloride levels.

MO870 Figure 1:

Chloride levels and diagnosis of COVID-19 pneumonia in chronic hemodialysis patients

Conclusion

Chronic hemodialysis patients with SARS-CoV-2 infection and lower serum chloride levels at hospital admission were more likely to develop pneumonia.

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Author and article information

Journal

Journal ID (nlm-ta): Nephrol Dial Transplant

Journal ID (iso-abbrev): Nephrol Dial Transplant

Journal ID (publisher-id): ndt

Title: Nephrology Dialysis Transplantation

Publisher: Oxford University Press

ISSN (Print): 0931-0509

ISSN (Electronic): 1460-2385

Publication date Collection: May 2021

Publication date (Electronic): 29 May 2021

Volume: 36

Issue: Suppl 1 , 58th ERA-EDTA Congress, 5–8 June 2021

Electronic Location Identifier: gfab098.0062

Affiliations

[gfab098.0062-aff1 ] Gran Canaria Dr. Negrin University Hospital , Nephrology, Las Palmas de Gran Canaria, Spain

[gfab098.0062-aff2 ] University of Las Palmas de Gran Canaria, Doctoral School. Biomedicine Research Program, Las Palmas de Gran Canaria , Spain

[gfab098.0062-aff3 ] Avericum S.L Dialysis Centers, Las Palmas de Gran Canaria , Spain

[gfab098.0062-aff4 ] Gran Canaria Dr. Negrin University Hospital, Intensive Care Unit, Las Palmas de Gran Canaria , Spain

[gfab098.0062-aff5 ] Gran Canaria Dr. Negrin University Hospital, Anesthesiology, Las Palmas de Gran Canaria , Spain

[gfab098.0062-aff6 ] Central Defense Gomez Ulla Hospital , Nephrology, Madrid, Spain

Article

Publisher ID: gfab098.0062

DOI: 10.1093/ndt/gfab098.0062

PMC ID: 8194994

SO-VID: e3416d43-7121-421f-90c4-23a246b65fcb

License:

This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)