Renal Involvement and Outcomes in Patients Hospitalized with COVID-19 Infection in A Tertiary Hospital

Abstract

Background Kidney involvement is seen frequently in COVID-19 patients and is essential to the prognosis. This study is undertaken to describe the clinical presentation of renal involvement in COVID-19 patients concerning acute kidney injury (AKI), chronic kidney disease (CKD), and urinary abnormalities and to correlate with the severity of COVID-19 illness and its outcome. Material and Methods A retrospective cross-sectional study reviewed the medical records of patients admitted with COVID-19 infection who had pre-existing renal conditions or renal manifestations in the form of deranged renal function tests or abnormal urinary findings. All the relevant clinical and laboratory parameters, including the treatment details and outcome, were noted, and statistical analysis was done. Results A total of 72 out of 1,544 patients satisfied the inclusion criteria. Hypertension (72%) and Diabetes (62%) were the commonest co-morbidities noted. CKD was seen in 51 (70%) patients, and 21 patients (29%) were on maintenance dialysis. 39 (76%) patients with CKD were diagnosed with severe COVID-19, 25 (49%) of the patients developed acute worsening of CKD, and 45% had mortality. AKI was seen in 19 patients (26%). Urinary abnormality was seen in 34 (47%) patients, out of which 27 (37%) had proteinuria of more than 1+. Haematuria was seen in 27 (37.5%) patients, of which 12(17%) had gross haematuria. Dialysis was required in 24 patients (33%) additionally. Mechanical ventilation was required in 32(44%) patients, and inotropes in 41(56%). 21 (29%) patients developed acute respiratory distress syndrome, 39 (54%) had sepsis, with six patients developing multiorgan dysfunction syndrome. 62.5% of patients had mortality. The presence of other comorbid conditions, thrombocytopenia, coagulopathy, abnormality in arterial blood gases, and usage of inotropes were found to be significantly associated with adverse outcomes. Conclusions Most cases had severe renal system involvement, with an AKI prevalence rate of 1.2% and a case-specific mortality rate of 62.5%.