Abstract
Background: Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome-Corona Virus 2 has generated significant impact on global health worldwide. COVID-19 can cause pneumonia and organ injury. Chronic kidney disease (CKD) has been associated with increased mortality in previous epidemics, but there is a paucity of data regarding actual risks for non-dialysis CKD patients with COVID-19.Methods: Multicenter, observational cohort study including 136 non-dialysis CKD patients and 136 age- and sex-matched controls that required hospitalization due to COVID-19. Patients with end-stage renal disease, a kidney transplant or without registered baseline glomerular filtration rate prior to COVID-19 infection were excluded. CKD and acute kidney injury (AKI) were defined according to KDIGO criteria.Results: CKD patients had higher white blood cell count and D-dimer and lower lymphocyte percentage. No differences were found regarding symptoms on admission. CKD was associated with higher rate of AKI (61 vs. 24.3%) and mortality (40.4 vs. 24.3%). Patients with AKI had the highest hazard for death (AKI/non-CKD HR:7.04, 95% CI:2.87–17.29; AKI/CKD HR:5.25, 95% CI: 2.29–12.02), followed by CKD subjects without AKI (HR:3.39, 95% CI:1.36–8.46). CKD status did not condition ICU admission or length of in-hospital stay.Conclusions: CKD patients that require hospitalization due to COVID-19 are exposed to higher risk of death and AKI.
Highlights
Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome-Corona Virus 2 has generated significant impact on global health worldwide
Chronic kidney disease (CKD) has been associated with increased mortality in previous epidemics, but there is a paucity of data regarding actual risks for non-dialysis CKD patients with COVID-19
CKD was associated with higher rate of acute kidney injury (AKI) (61 vs. 24.3%) and mortality (40.4 vs. 24.3%)
Summary
Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome-Corona Virus 2 has generated significant impact on global health worldwide. Reported COVID-19 mortality rates are subject to wide variability, with initial reports from China pointing to fluctuating infection-associated death rates, between 11 and 45% among hospitalized patients [5,6,7]. Age, preexisting conditions such as cardiovascular, cerebrovascular or other underlying diseases, and abnormal inflammatory markers such as low absolute lymphocyte count or elevated D-dimer, C-reactive protein (CRP), or interleukin-6 (IL6) have been associated with increased risk of death [6, 7]. A series of recommendations have been published aiming to mitigate the impact of the pandemic in dialysis and transplant patients [15, 16]
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