Abstract
Background: Increasing evidence revealed that kidney was one of the targets of SARS-CoV-2. However, the incidences of kidney abnormalities were significantly different, from 0·5 to 75·4% in coronavirus disease 2019 (COVID-19) patients. The association of kidney injury with prognosis remain controversial.Methods: In this retrospective cohort study, laboratory confirmed COVID-19 in patients with severe type were enrolled. Demographic, clinical, and laboratory data were collected. Association of estimated glomerular filtration rate (eGFR) with 28-days mortality was analyzed.Findings: The total 28-days mortality of hospitalization was 22·3% (79/354). Non-survivors had a significantly declined eGFR levels than survivors (75·95 [IQR: 47·22,92·84] ml/min/1·73m2 vs. 96·43 [IQR: 84·11,108·47] ml/min/1·73m2, P 2) was significantly higher than that in normal eGFR group (38·5% vs. 10·7%, P Interpretation: Declined eGFR was associated with poor prognosis, and could be used an independent risk factor of 28-days mortality in COVID-19 patients. Early detection, and surveillance for eGFR may benefit to identify patients with high-risk of progression.Funding Information: Program of Key Talents of Medical Science in Jiangsu Province, Suzhou science and technology development plan.Declaration of Interests: The authors have declared that no conflict of interest exists.Ethics Approval Statement: This study was approved by the institutional review boards at the First Affiliated Hospital of Soochow University and Wuhan Tongji Hospital. As COVID-19 is an emerging infectious disease, the written informed consent was exempted.
Highlights
Increasing evidence revealed that kidney was one of the targets of SARS-CoV-2
The 28-days mortality in declined estimated glomerular fifiltration rate (eGFR) group (
Multivariate logistic regression revealed that the independent risk factors of 28-days outcome included lower eGFR (OR: 3.97, 95%CI: 1.42-11.11), elevated white blood cell (WBC) (OR: 7.08, 95%CI: 3.15-15.90), lymphopenia (OR: 2.58, 95%CI: 1.21-5.49)andIL-6 (OR: 7.90, 95%CI: 2.19-28.49)
Summary
The incidences of kidney abnormalities were significantly different, from 0.5 to 75.4% in coronavirus disease 2019 (COVID-19) patients. Lungs were the main targets of SARS-CoV-2, increasing evidence revealed that SARS-CoV-2 infection could be found out of lung, such as digestive system, cardiovascular system and kidney [2]. Some studies revealed acute kidney injury (AKI) occurred in 2.9–23% of ICU patients [3,4,5]. A recent study showed that kidney diseases was associated with in-hospital death of patients with COVID-19 [3]. Another report indicated that COVID-19 did not result in acute kidney injury (AKI) [6]. This might be due to the different methods of kidney injury evaluation and definition. Serum creatinine remains the most widely used biomarker to evaluate renal function, it is a delayed renal functional marker when it is generally increased after sever kidney damage [8]
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