Introduction
In December 2019, the first outbreak of coronavirus disease (COVID-19) was reported but rapidly became a pandemic disease. Several comorbidities present in COVID-19 patients were demonstrated to be associated with a greater risk of severe disease and higher mortality rate. Chronic kidney disease (CKD) patients represent a vulnerable population of acquiring severe COVID-19, as they present with a higher percentage of comorbidities. The main purpose of this study was to analyse the impact of CKD in COVID-19 hospitalized patients.
Methods
A retrospective analysis of 572 hospitalized patients admitted to a Dedicated Unit for COVID-19 patients in a hospital in Lisbon, Portugal, between March 2020 and August 2020. Patients on renal replacement therapy were excluded.
Results
CKD was present in 22.7% of the COVID-19 analysed population. Patients with CKD were significantly older and more likely to have pre-existing hypertension (81.5% vs 52.9%; p<0.001), diabetes (36.2% vs 24.4%, p=0.008), cardiovascular disease (CVD) (54.6% vs 26.7%; p<0.001) and heart failure (51.5% vs 17.6%; p<0.001). Regarding clinical presentation, fever was more frequent in patients without CKD (37.7% vs 56.1%). Acute kidney injury (AKI) was more frequent in patients with CKD (80.8% vs 57.5%, p<0.001). Discharge while on haemodialysis (HD) occurred more often in CKD patients (16.9% vs 0.2%, p<0.001). In-hospital mortality was significantly higher in CKD patients (26.2% vs 10.9%, p<0.001). On a multivariate analysis, older age (adjusted OR 1.06 (95% CI 1.03-1.08), p<0.001), CKD (adjusted odds ratio (OR) 2.34 (95% CI 1.32-4.14), p=0.004), and neoplasia (adjusted OR 3.63 (95% CI 1.91-6.91), p<0.001) were independent predictors of mortality in this cohort.
Conclusions
This study shows the importance that should be given to CKD as a comorbidity, as CKD was a frequent diagnosis and significantly associated with mortality. Considering the prevalence of COVID-19 in CKD patients, preventive measures of contagion of COVID-19 should be undertaken in a stricter manner in this population, as well as a rigorous medical follow up concerning renal disease.
No conflict of interest