Abstract
COVID-19 remains a major world health problem, and its clinical manifestations can vary from an oligosymptomatic form to severe pulmonary infection, which can require invasive ventilation and is strictly related to death. Identifying risk factors for adverse outcomes is essential for performing adequate care and contrasting high mortality. Chronic kidney disease (CKD) is a widespread comorbidity and is a known risk factor for death during SARS-CoV-2 infection. The present study evaluates the death risk assessment during the COVID-19 pandemic in (CKD) patients, considering the baseline value of an estimated glomerular filtration rate (eGFR) and other possible risk factors. We retrospectively assessed the mortality risk in 150 patients with COVID-19 between 1 October and 31 December 2020. We evaluated eGFR, haemoglobin, albumin, uric acid, cholesterol, triglycerides, and significant risk factors, such as diabetes mellitus and cardiovascular disease in every patient. We had 53 deaths (35.3%) during the observational period, significantly related to age, eGFR, albumin, and baseline nephropathy. In the multivariable analysis, only baseline eGFR and age were independent predictors of death during SARS-CoV-2 infection, with an OR equal to 0.96 and 1.067, respectively. In conclusion, by our analysis, age, and the baseline eGFR were the only reliable predictors of death during COVID-19 in CKD patients.
Highlights
Coronavirus disease (COVID-19) is still a major world health problem, considering more than 280 million subjects had SARS-CoV-2 infection, of whom more than five million died [1]
The patients who died were significantly older, with a worse baseline kidney function evaluated by estimated glomerular filtration rate (eGFR) and lower baseline albumin levels (Table 1)
Baseline eGFR values were significantly lower in those patients who died 22 (IQR:12–42) mL/min/1.73 m2 vs. 44 (IQR:22–59) mL/min/1.73 m2 in those patients who survived; p < 0.001)
Summary
Coronavirus disease (COVID-19) is still a major world health problem, considering more than 280 million subjects had SARS-CoV-2 infection, of whom more than five million died [1]. Predictive factors identification remains essential to identify patients with a higher risk of severe manifestations and mortality. Chronic kidney disease (CKD) is a widespread morbidity with a global mean prevalence of around 13% [2], and it is a progressive disease, classified in five stages of severity by the estimation of glomerular filtration rate (eGFR) [3]. Stage V CKD patients (eGFR under 15 mL/min/1.73 m2 ) can present peculiar symptoms (nausea, vomiting, itch, and asthenia) and biochemical impairment (sodium and potassium impairment, calcium, and phosphate impairment, anaemia, metabolic acidosis), which can require replacement therapy, such as haemodialysis, peritoneal dialysis, and kidney transplantation. CKD is considered the most prevalent risk factor [4]
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