Kidney dysfunction and mortality risk in hospitalized Covid-19 patients: A large Covid-19 centre experience

Abstract

Objective: Kidney dysfunction is common in patients infected with the coronavirus (COVID-19). The study's objective was to determine  the relationship between glomerular filtration rate and mortality in COVID-19 patients. Methods: This is a retrospective cohort study of patients admitted into the COVID-19 isolation center from March 2020 through  December 2021. The serum creatinine at admission was used to estimate the glomerular filtration rate (eGFR) using the CKD equation  method. The patients were categorized into 2 groups based on the eGFR (≥ or < 60ml/minute). The outcome was in-hospital mortality.  Kaplan Meier survival plots and cox proportional modelling were employed in the data analysis. Results: Atotal of 623 patients were analysed. The mean age was 53.4±15.3 years, and 58.6% were male. An eGFR of < 60 ml/min was  observed in 196 (31%) patients. A significantly higher number of deaths occurred among patients with eGFR <60ml/min (32% vs 10.5%  (P<0.001). After adjusting for age, sex, disease severity, haemoglobin, ICU admission, and dialysis, the patients with reduced eGFR of (<60ml/min) were twice more likely to die than patients with eGFR ≥60mls/min(AHR 1.95, 95% CI 1.26- 3.04, P= 0.003). Conclusion: eGFR of < 60mls/min is associated with an increased risk of mortality in COVID-19 patients. This stresses the need for better  recognition of renal dysfunction as a high-risk for mortality in COVID-19 infections.