Gastrointestinal manifestations of long-term effects after COVID-19 infection in patients with dialysis or kidney transplantation: An observational cohort study

Table 1 Baseline characteristics and clinical presentation of corona virus disease 2019 in participants with or without gastrointestinal tract symptoms related to prolonged symptoms after corona virus disease 2019 at enrollment

Variables	Hemodialysis (n = 524)	Peritoneal dialysis (n = 34)	Kidney Transplantation (n = 19)	P value
Age, yr, mean ± SD	48 ± 9	71 ± 12	44 ± 12	< 0.001a,b
Female sex, n (%)	278 (53.1)	14 (41.2)	8 (42.1)	NS
Body mass index, kg/m2, mean ± SD	26 ± 4	23 ± 2	24 ± 4	< 0.001a
Comorbidities, n (%)
Hypertension	487 (92.9)	34 (100)	12 (63.2)	< 0.0001b, 0.0002c
Diabetes	408 (77.9)	30 (88.2)	6 (31.6)	< 0.0001b,c
Cardiovascular disease	450 (85.9)	28 (82.4)	9 (47.4)	< 0.0001b, 0.008c
Pulmonary disease	52 (9.9)	5 (14.7)	1 (5.3)	NS
Hepatic disease	14 (2.7)	4 (11.8)	0 (0)	0.004a
Renal replacement therapy
Dialysis vintage, years	7 ± 3	5 ± 1	6 ± 2	< 0.001a
Frequency, 2× per week, n (%)	84 (16.0)	N/A	N/A
Frequency, 3× per week, n (%)	440 (84.0)	N/A	N/A
CAPD, n (%)	N/A	32 (94.1)	N/A
APD, n (%)	N/A	2 (5.9)	N/A
Deceased donor transplant, n (%)	N/A	N/A	11 (57.9)
Time from transplant, yr, mean ± SD	N/A	N/A	6 ± 2	< 0.001b,c
Maintenance immunosuppressive regimen by drug, n (%)
Calcineurin inhibitors
TAC	N/A	N/A	11 (57.9)
CsA	N/A	N/A	8 (42.1)
Prednisolone	N/A	N/A	19 (100)
Antimetabolites
MPA	N/A	N/A	16 (84.2)
Azathioprine	N/A	N/A	0 (0)
mTOR inhibitors	N/A	N/A	3 (15.8)
Baseline creatinine, mean ± SD	8 ± 2	11 ± 2	2.5 ± 0.8	< 0.001a,b,c
Baseline creatinine > 1.5 mg/dL, n (%)1	N/A	N/A	7 (36.8)
Day(s) of illness, mean ± SD	4 ± 2	3 ± 1	3 ± 1	< 0.001a
Initial symptoms, n (%)
Fever or chills	511 (97.5)	34 (100)	19 (100)	NS
Cough	488 (93.1)	34 (100)	18 (94.7)	NS
Dyspnea	321 (61.3)	30 (88.2)	16 (84.2)	0.002a, 0.043b
Chest pain	152 (29.0)	11 (32.4)	8 (42.1)	NS
Coryza	501 (95.6)	34 (100)	19 (100)	NS
Headache	161 (30.7)	5 (14.7)	6 (31.6)	0.048a
Nasal congestion	359 (68.5)	9 (26.5)	11 (57.9)	< 0.0001a, 0.025c
Fatigue	209 (40.0)	34 (100)	9 (47.4)	< 0.0001a, < 0.0001c
Myalgia	386 (73.7)	31 (91.2)	12 (63.2)	0.023a, 0.013c
Nausea or vomiting	137 (26.1)	30 (88.2)	4 (21.1)	< 0.0001a,c
Diarrhea	83 (15.8)	25 (73.5)	3 (15.8)	< 0.0001a,c
Anosmia	66 (12.6)	7 (20.6)	1 (5.3)	NS
Ageusia	25 (4.8)	6 (17.6)	2 (10.5)	0.002a
Number of symptoms, mean ± SD	7 ± 2	9 ± 1	4 ± 2	< 0.0001a,b,c
COVID-19 severity, n (%)
Mild	252 (48.1)	2 (5.9)	0 (0)	< 0.0001a,b
Moderate	137 (26.1)	7 (20.6)	4 (21.1)	NS
Severe	135 (25.8)	25 (73.5)	0 (0)	< 0.0001a,c, 0.011b
High-sensitivity C-reactive protein (mg/L)	32 ± 14	59 ± 11	17 ± 9	< 0.0001a,b,c
D-dimer (ng/mL)	2749 ± 578	5339 ± 786	1699 ± 175	< 0.0001a,b,c
Treatments, n (%)
Remdesivir	352 (67.2)	30 (88.2)	8 (42.1)	0.011a, 0.023b, 0.0004c
Favipiravir	172 (32.8)	4 (11.8)	11 (57.9)	0.011a, 0.023b, < 0.001c
Tocilizumab	39 (7.4)	12 (63.1)	0 (0)	< 0.0001a,c
Corticosteroids	429 (81.9)	34 (100)	19 (100)	0.007a, 0.041b
Low-molecular weight heparin	482 (92.0)	32 (94.1)	7 (36.8)	< 0.0001b,c
Outcomes during the acute phase, n (%)
Hospitalization	524 (100)	34 (100)	19 (100)	-
Intensive care unit	204 (38.9)	27 (79.4)	4 (21.1)	< 0.0001a,c
Oxygen therapy	272 (51.9)	32 (94.1)	4 (21.1)	< 0.0001a,c, 0.008b
Invasive mechanical ventilation	104 (19.8)	23 (67.6)	0 (0)	< 0.0001a,c, 0.031b
Increased dialysis frequency	178 (34.0)	0 (0)	N/A	< 0.0001a
Immunosuppression suspended except for steroids1	N/A	N/A	2 (10.5)

¹Only kidney transplant recipient group.

Only the comparisons between following groups with statistical significance are shown.

^aHemodialysis vs peritoneal dialysis group.

^bHemodialysis vs kidney transplantation group.

^cPeritoneal dialysis vs kidney transplantation group.

APD: Automated peritoneal dialysis; COVID-19: Coronavirus disease 2019; CAPD: Continuous ambulatory peritoneal dialysis; CsA: Cyclosporin A; MPA: Mycophenolate; mTORi: Mammalian target of rapamycin inhibitors; TAC: Tacrolimus; N/A: Not applicable; NS: Non-significant.