#4690 INFLUENCE OF CHRONIC KIDNEY DISEASE AND GLOMERULAR FILTRATION RATE ON THE COURSE OF ACUTE SARS-COV-2 INFECTION AND POST-COVID PERIOD

Abstract

Abstract Background and Aims According to international data available in the literature, chronic kidney disease (CKD) may have a significant impact on the course and outcome of COVID-19. Moreover, kidney pathology have been suggested to aggravate the course of the post-COVID period. The aim of the study was to investigate the effect of CKD and glomerular filtration rate (GFR) on the course of acute infection and post-COVID period. Method An international register “Dynamics analysis of comorbidities in SAES-CoV-2 survivors” (ACTIV) (NCT04492384) was established to assess the characteristics of the course of NCI in the Eurasian region. Specialists from 7 countries participated in the register. ACTIV is a multicenter, non-interventional, real-world clinical practice registry that included men and women over 18 years of age with a confirmed diagnosis of COVID-19. The analysis presented is based on data from 8496 patients with an estimated GFR of ≥90 ml/min/1.73 m2 - 3591 (42.3%) patients, 89-60 ml/min/1.73 m2 3105 (36.5%) patients, 59-45 ml/min/1.73 m2 - 1132 (13.3%) patients, 44-30 ml/min/1.73 m2 - 433 (5.10%) patients, 29 -15 ml/min/1.73 m2 - 141 (1.7%) patients, <15 ml/min/1.73 m2 - 94 (1.1%) patients. GFR was calculated using the 2021 CKD-EPI formula. The post-COVID period was analyzed using data from telephone interviews that included 3099 patients at 3 months, 2493 patients at 6 months, and 1782 patients at 12 months after recovery from COVID-19. Results During the acute infection, patients with a GFR of 59-15 ml/min/1.73 m2, had more severe lung tissue damage (stage 3-4 according to computed tomography (CT), p < 0.001) and worse oxygenation (SpO2 75-94% and less than 75%, p < 0.001); increased respiratory rate (over 22 per minute, p < 0.001); and higher body temperature (more than 38.6°C, p < 0.001) compared with patients with GFR over 60 ml/min/1.73 m2. In addition, CKD increased the odds of death in hospitalized patients by 3.94-fold compared with patients without CKD (95% confidence interval (CI) 3.15-4.89, p < 0.001). The data of the deceased patients showed that most of them had a GFR of 89–60 ml/min/1.73 m2, which corresponds to stage 2 CKD (Table 1). CKD was a risk factor for increased odds of death in the post-COVID period: 4.88-fold (95% CI 2.42-9.13; p < 0.001) within 3 months; 4.24-fold (95% CI 0.60-16.3; p = 0.126) within 6 months and 8.36 -fold (95% CI 1.73-29.3; p = 0.112) within 12 months after recovery from SARS-CoV-2. Conclusion CKD could be a predictor of a more severe acute period of COVID-19 and also significantly impact mortality within 12 months after recovery from SARS-CoV-2.