The Clinical Course and Prognostic Factors of COVID-19 in Patients with Chronic Kidney Disease, A Study in Six Centers

Authors

  • Neda Najafi Department of Nephrology, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran
  • Roghayeh Akbari Department of Nephrology, Ayatollah Rouhani Hospital, Shahid Beheshti Hospital, Babol University of Medical Sciences, Mazandaran, Iran
  • Zahra Lotfi Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  • Atieh Makhough Department of Nephrology, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Mazandaran, Iran
  • Mohsen Vahedi Department of Biostatistics and Epidemiology, Faculty of Rehabilitation Sciences, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • Masoumeh Asgharpour Department of Nephrology, Ayatollah Rouhani hospital, Babol University of Medical Sciences, Mazandaran, Iran
  • Mahin Ghorban Sabagh Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  • Bahareh Marghoob Department of Nephrology, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran
  • Narges Mirzaei Ilali Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Mazandaran, Iran
  • Fereshteh Saddadi Department of Nephrology, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran
  • Zahra Shams Ayatollah Rouhani Hospital, Shahid Beheshti Hospital, Babol University of Medical Sciences, Mazandaran, Iran
  • Sharzad ossareh Department of Nephrology, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran

Abstract

Introduction. Coronavirus disease 19 (COVID-19), has recently emerged as a great health challenge. The novel corona virus may affect the kidneys mainly as acute kidney injury (AKI). Also, the outcome of COVID-19 may be different in patients with underlying kidney disease. The aim of this study was to compare the outcome of COVID-19 in patients with and without underlying kidney disease. Methods. This was a retrospective study on 659 hospitalized COVID-19 patients in six centers of Iran. Patients were classified into kidney (chronic kidney disease (CKD), end-stage kidney disease (ESKD) or kidney transplantation) and non-kidney groups. The clinical conditions and laboratory data were extracted from the charts. Outcome was defined as death during hospitalization or within 30 days of discharge. Results. Among 659 COVID-19 patients (mean age: 60.7 ± 16.4, 56% male), 208 were in the kidney group (86 ESKD, 35 kidney transplants, and 87 CKD patients). AKI occurred in 41.8%. Incidence of AKI was 34.7% in non-kidney, 74.7% in CKD, and 51.4% in kidney transplant patients (P < .001). Totally 178 patients (27%) died and mortality rate was significantly higher in CKD patients (50.6 vs. 23.4%, P < .001). AKI was associated with increased mortality rate (OR = 2.588, CI: 1.707 to 3.925). Initial glomerular filtration rate (GFR) < 44.2 mL/min and elevated lactate dehydrogenase (LDH) and C-reactive protein (CRP) had significant association with mortality. Conclusion. We showed a higher mortality rate in COVID-19 patients with AKI and CKD. Low initial GFR and elevated LDH and CRP were associated with high mortality in COVID-19 patients.

DOI: 10.52547/ijkd.6132

Author Biographies

  • Neda Najafi, Department of Nephrology, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran

    Department of nephrology, Hashaminejad Kidney Center,  Iran University of Medical Sciences, Tehran, Iran. Assistant Professor of nephrology 

  • Roghayeh Akbari, Department of Nephrology, Ayatollah Rouhani Hospital, Shahid Beheshti Hospital, Babol University of Medical Sciences, Mazandaran, Iran

    Department of nephrology, Ayatollah Rouhani hospital, Shahid Beheshti hospital,  Babol University of Medical Sciences, Mazandaran, Iran. Associate professor of nephrology.

  • Zahra Lotfi, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
    Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Assistant professor of nephrology.
  • Atieh Makhough, Department of Nephrology, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Mazandaran, Iran
    Department of nephrology, Imam Khomeini hospital,  Mazandaran University of Medical Sciences, Mazandaran, Iran. Professor of nephrology . 
  • Mohsen Vahedi, Department of Biostatistics and Epidemiology, Faculty of Rehabilitation Sciences, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

     Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Assistant Professor of Biostatistics .  

  • Masoumeh Asgharpour, Department of Nephrology, Ayatollah Rouhani hospital, Babol University of Medical Sciences, Mazandaran, Iran

     Department of nephrology, Ayatollah Rouhani hospital,  Babol University of Medical Sciences, Mazandaran, Iran.Assistant Professor of nephrology  

  • Mahin Ghorban Sabagh, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Assistant professor of nephrology.

  • Bahareh Marghoob, Department of Nephrology, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran

    Department of nephrology, Hashaminejad Kidney Center,  Iran University of Medical Sciences, Tehran, Iran. Assistant Professor Of Nephrology                    

     

  • Narges Mirzaei Ilali, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Mazandaran, Iran

    Imam Khomeini hospital, Mazandaran University of Medical Sciences, Mazandaran, Iran. Resident of internal medicine.

  • Fereshteh Saddadi, Department of Nephrology, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran

    Department of nephrology, Hashaminejad Kidney Center,  Iran University of Medical Sciences, Tehran, Iran. Associate Professor Of Nephrology                                             

  • Zahra Shams, Ayatollah Rouhani Hospital, Shahid Beheshti Hospital, Babol University of Medical Sciences, Mazandaran, Iran
    Ayatollah Rouhani hospital, Shahid Beheshti hospital, Babol University of Medical Sciences, Mazandaran, Iran. Resident of internal medicine. 
  • Sharzad ossareh, Department of Nephrology, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran
    Professor of Medicine, Director of Nephrology and Fellowship Program, Hasheminejad Kidney Center, Iran University of Medical Sciences

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Published

2021-07-19

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Section

ORIGINAL | Kidney Diseases