Kidney Dysfunction and Its Progression in Patients Hospitalized Duo to COVID-19: Contribution to the Clinical Course and Outcomes

Abstract

The disease caused by coronavirus SARS-CoV-2 (COVID-19) can affect almost all organs of the human body, including kidneys. We conducted a one-center study to comprehensively analyze the effects of kidney involvement on the course and outcomes in patients hospitalized with COVID-19, depending on the estimated glomerular filtration rate (eGFR) at admission. Out of the 1958 patients, 1342 (68.54%) had eGFR ≥ 60 mL/min/1.73 m2 (group A) and 616 (31.46%) had eGFR < 60 mL/min/1.73 m2 (group B). Group B was additionally divided into subgroups B1, B2, and B3 based on eGFR. We found that mortality rates during hospitalization, as well as after 90 and 180 days, were much higher in group B than group A. The highest mortality was observed in the B2 subgroup with eGFR of 15–29. The mortality of B patients was associated with comorbidities, respiratory dysfunction, immunological impairment, and more frequent development of AKI. AKI had a negative impact on patients’ survival, regardless of the initial renal function. At discharge, 7.4% of patients had serum creatinine levels 30% higher, or more, as compared to admission. The disease course and outcomes in COVID-19 patients are associated with baseline eGFR; however, AKI during hospitalization is a more significant predictor of poor prognosis regardless of the initial renal function.

Association of serum vitamin D concentration with the final course of hospitalization in patients with COVID-19

“…Mortality in Group B patients was associated with comorbidities, immune impairment, and the frequent development of acute kidney injury. This study showed that the baseline eGFR values determine the course of COVID-19 ( 51 ). Our current study also showed that vitamin D concentrations are a significant risk factor for mortality and COVID-19, and patients with lower vitamin D concentrations have a worse prognosis.…”

“…In our previous study, we assessed renal function, according to eGFR values, in patients admitted to the hospital due to COVID-19 ( 51 ). Mortality during hospitalization and after 90 and 180 days was significantly higher in the patients with an eGFR < 60 ml/min/1.73 m 2 (Group B) compared to patients with eGFR values ≥ 60 ml/min/1.73 m 2 (Group A) (p < 0.001) ( 51 ). Mortality in Group B patients was associated with comorbidities, immune impairment, and the frequent development of acute kidney injury.…”

The Role of Extracellular Vesicles in SARS-CoV-2-Induced Acute Kidney Injury: An Overview

“…Stage 2 sCR 2.0-2.9 times baseline and/or urine output < 0.5 mL/kg/h for ≥12 h As SARS-CoV-2 began to spread globally, reports regarding the relationship between AKI and COVID-19 were noticeable, and incident rates were as low as 0.5% in China [69] and as high as 80% in critically ill COVID-19 patients in France [70]. As time progressed and SARS-CoV-2 infection spread to diverse geographic regions around the world, large cohort studies from Africa [71], China [72], England [73], India [74], Iran [75], Italy [76], Poland [77], Portugal [78], Spain [79], UK [80][81][82], and USA [83,84] have reported varying incidence rates of AKI among patients with COVID-19. The outcomes of these studies are summarized in Table 2.…”

A Case-Control of Patients with COVID-19 to Explore the Association of Previous Hospitalisation Use of Medication on the Mortality of COVID-19 Disease: A Propensity Score Matching Analysis

“…Chronic kidney disease, associated with linagliptin in the PSM interaction analysis, seems to be associated with enhanced risk of COVID-19 mortality. The disease course and outcomes in COVID-19 patients are associated with baseline estimated glomerular filtration rate [32].…”