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Xiangqin Cui, PhD.

Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE, Atlanta, GA 30322.

Phone: (404)727-3743

xiangqin.cui@emory.edu

Michal Mrug, MD.

Division of Nephrology, University of Alabama at Birmingham, 1900 University Blvd, THT 611J, Birmingham, AL 35294.

Phone: (205) 934-9509

mmrug@uab.edu

X.C., J.G., C.J. and M.M. conceived and designed the research; X.C., J.G., C.J. and M.M. performed the experiments and carried out the analyses; X.C., J.G., C.J. and M.M. analyzed the data; X.C., J.G., C.J. and M.M. interpreted the results of experiments; X.C., C.J. prepared the figures and tables; X.C. and M.M. drafted the manuscript; X.C., J.G., C.J. and M.M. edited and revised the manuscript; X.C., J.G., C.J. and M.M. approved the final version of manuscript.

M. M. reports grants and consulting fees outside the submitted work from Otsuka Pharmaceuticals, Sanofi, Chinook and Natera.

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Research Funding:

Support was provided in part by the PKD Foundation research grant 247G20a (to X.C.), Atlanta VA Medical Center Research Office (X.C., J.W.G, C.J.), and by the National Institutes of Health (NIH)-funded University of Alabama at Birmingham (UAB) Hepato/Renal Fibrocystic Disease Core Center P30 DK074038 and Childhood Cystic Kidney Disease Core Center U54DK126087, the 1-I01-BX004232-01A2 grant from the Office of Research and Development, Medical Research Service, Department of Veterans Affairs and by the Detraz Endowed Research Fund in Polycystic Kidney Disease (to M. M.).

Autosomal Dominant Polycystic Kidney Disease does not significantly alter major COVID-19 outcomes among veterans.

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Journal Title:

medRxiv

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Type of Work:

Article | Preprint: Prior to Peer Review

Abstract:

Chronic kidney disease (CKD), as well as its common causes (e.g., diabetes and obesity), are recognized risk factors for severe COVID-19 illness. To explore whether the most common inherited cause of CKD, autosomal dominant polycystic kidney disease (ADPKD), is also an independent risk factor, we studied data from the VA health system and the VA COVID-19-shared resources (e.g., ICD codes, demographics, pre-existing conditions, pre-testing symptoms, and post-testing outcomes). Among 61 COVID-19-positive ADPKD patients, 21 (34.4%) were hospitalized, 10 (16.4%) were admitted to ICU, 4 (6.6%) required ventilator, and 4 (6.6%) died by August 18, 2020. These rates were comparable to patients with other cystic kidney diseases and cystic liver-only diseases. ADPKD was not a significant risk factor for any of the four outcomes in multivariable logistic regression analyses when compared with other cystic kidney diseases and cystic liver-only diseases. In contrast, diabetes was a significant risk factor for hospitalization [OR 2.30 (1.61, 3.30), p<0.001], ICU admission [OR 2.23 (1.47, 3.42), p<0.001], and ventilator requirement [OR 2.20 (1.27, 3.88), p=0.005]. Black race significantly increased the risk for ventilator requirement [OR 2.00 (1.18, 3.44), p=0.011] and mortality [OR 1.60 (1.02, 2.51), p=0.040]. We also examined the outcome of starting dialysis after COVID-19 confirmation. The main risk factor for starting dialysis was CKD [OR 6.37 (2.43, 16.7)] and Black race [OR 3.47 (1.48, 8.1)]. After controlling for CKD, ADPKD did not significantly increase the risk for newly starting dialysis comparing with other cystic kidney diseases and cystic liver-only diseases. In summary, ADPKD did not significantly alter major COVID-19 outcomes among veterans when compared to other cystic kidney and liver patients.

Copyright information:

2020

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/rdf).
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