Is Chronic Kidney Disease, a Predictor of In-Hospital Mortality in Coronavirus Disease 2019 (COVID-19) Patients?

Firouzeh Moeinzadeh, Vahideh Raeisi, Media Babahajiani, Mojgan Mortazavi, Samaneh Pourajam, Shiva Seirafian, Mohammad Shirzadi, Shahram Taheri, Mehrdad Salahi, Marjan Mansourian, Arash Toghyani, Zahra Zamani
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Abstract

Background: Chronic kidney disease (CKD) is an important comorbidity in Coronavirus Disease 2019 (COVID-19) patients considering its high prevalence. We aimed to figure out the relationship between CKD and COVID-19 mortality in this study.

Materials and methods: In total, 116 CKD patients (estimated glomerular filtration rate [eGFR] lower than 60 mL/min/1.73 m2) and 147 control subjects confirmed with COVID-19 were studied. Data regarding demographics, sign and symptoms, laboratory findings, and chest computed tomography were collected. Association between CKD and in-hospital mortality were analyzed using logistic regression models adjusted for confounders.

Results: Mortality rate was significantly higher in CKD than non-CKD (30.17 vs 4.76, P < 0.001) COVID-19 patients. Multivariate logistic regression showed that CKD was significantly correlated with in-hospital mortality in the total sample (Odds ratio (OR) = 8.64, confidence interval (CI): 3.67-20.35) and gender subgroups (females: OR = 4.77, CI: 1.38-16.40, males: OR = 13.43, CI: 3.85-46.87) (P < 0.05) of COVID-19 patients in the crude model. Whereas, the correlation did not remain significant in the fully adjusted model in the total sample (OR = 1.70, CI: 0.35-8.19) and gender subgroups (females: OR = 1.07 CI: 0.06-19.82, males: OR = 0.87, CI: 0.07-10.33) (P > 0.05) of COVID-19 patients.

Conclusion: This study suggested an independent association between CKD and in-hospital mortality in COVID-19 patients. Therefore, more intensive surveillance of COVID-19 patients with CKD is to be warranted.

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慢性肾脏疾病是2019冠状病毒病(COVID-19)患者住院死亡率的预测因子吗?
背景:慢性肾脏疾病(CKD)是冠状病毒病2019 (COVID-19)患者的重要合并症,其患病率很高。在本研究中,我们旨在找出CKD与COVID-19死亡率之间的关系。材料与方法:共纳入116例CKD患者(肾小球滤过率[eGFR]估计低于60 mL/min/1.73 m2)和147例确诊为COVID-19的对照组。收集了有关人口统计学、体征和症状、实验室结果和胸部计算机断层扫描的数据。使用经混杂因素校正的logistic回归模型分析CKD与住院死亡率之间的关系。结果:CKD患者的死亡率明显高于非CKD患者(30.17 vs 4.76, P < 0.001)。多因素logistic回归显示,在粗模型中,总样本(优势比(OR) = 8.64,置信区间(CI): 3.67 ~ 20.35)和性别亚组(女性:OR = 4.77, CI: 1.38 ~ 16.40,男性:OR = 13.43, CI: 3.85 ~ 46.87)中,CKD与住院死亡率显著相关(P < 0.05)。然而,在完全调整模型中,COVID-19患者的总样本(OR = 1.70, CI: 0.35 ~ 8.19)和性别亚组(女性:OR = 1.07 CI: 0.06 ~ 19.82,男性:OR = 0.87, CI: 0.07 ~ 10.33)的相关性不显著(P > 0.05)。结论:本研究提示COVID-19患者CKD与住院死亡率之间存在独立关联。因此,有必要对COVID-19合并CKD的患者进行更密切的监测。
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