Prognostic value of kidney involvement in COVID-19

  • Guillermo Fragale Servicio de Nefrología y Trasplante Renal, Hospital Universitario Austral, Universidad Austral, Pilar, Buenos Aires, Argentina
  • Matías Tisi Baña Servicio de Clínica Médica, Hospital Universitario Austral, Universidad Austral, Pilar, Buenos Aires, Argentina
  • Mauro Magenta Servicio de Nefrología y Trasplante Renal, Hospital Universitario Austral, Universidad Austral, Pilar, Buenos Aires, Argentina
  • Vanina Beitia Servicio de Nefrología y Trasplante Renal, Hospital Universitario Austral, Universidad Austral, Pilar, Buenos Aires, Argentina
  • Alejandra Karl Servicio de Nefrología y Trasplante Renal, Hospital Universitario Austral, Universidad Austral, Pilar, Buenos Aires, Argentina
  • Lina Rodríguez Cortés Servicio de Clínica Médica, Hospital Universitario Austral, Universidad Austral, Pilar, Buenos Aires, Argentina
  • Victoria Pousa Unidad de Terapia Intensiva, Hospital Universitario Austral, Universidad Austral, Pilar, Buenos Aires, Argentina
Keywords: COVID-19, coronavirus, severe acute respiratory syndrome, SARS-CoV-2, acute kidney injury, prognosis

Abstract

Introduction: Acute kidney injury is a complication described in patients with SARS-CoV-2 infection that is around 0.5-7% of cases. Objective: evaluate the prognostic value of kidney involvement in patients hospitalized for COVID-19 disease. Methods: A prospective cohort of patients over 18 years with a diagnosis of COVID-19 disease in the period from May to October 2020 was analyzed. All were followed up until hospital discharge or death. Clinical and biochemical parameters, Charlson score, mortality and severity of COVID-19 disease were evaluated. Results: Four hundred twelve patients entered the study, 57% men and mean age 51 ± 16 years. Twenty percent had a Charlson score ≥3, the incidence of acute kidney injury, defined as the increase in serum creatinine 0.3 mg / dl from baseline, was 5.5% (n=23) and hospital mortality was 2.2% (n = 9). The bivariate and multivariate analysis showed that the male sex [OR=0.32 (IC 0.12-0.82), p=0.017], D-dimer> 500 ng/ml [OR=3.68 (IC 1.23-10.96), p=0.019], urinary protein/creatinine > 0.20 [OR=2.43 (CI 1.03-5.74), p=0.043], and AKI [OR=10.53 (CI 2.99-37.09), p=<0.0001] were predictors of severe COVID-19, defined as respiratory rate >30 x min, oxygen saturation <93% or PO2/FIO2 <300. The univariate analysis of mortality was associated with the development of severe COVID-19 [OR=68.76 (CI 8.39-563.36), p=<0.0001] and acute kidney injury [OR=45.41 (CI 10.45-197.22), p=<0.0001]. Conclusion: Renal involvement is associated with worse evolution and higher mortality in COVID-19. The assessment of renal function and proteinuria are accessible parameters that should be included as risk factors in the initial evaluation of these patients.

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Published
2022-03-11
How to Cite
1.
Fragale G, Tisi Baña M, Magenta M, Beitia V, Karl A, Rodríguez Cortés L, Victoria Pousa. Prognostic value of kidney involvement in COVID-19. Rev Nefrol Dial Traspl. [Internet]. 2022Mar.11 [cited 2024Dec.27];42(1):4-10. Available from: http://vps-1689312-x.dattaweb.com/index.php/rndt/article/view/752
Issue
Vol. 42 No. 1 (2022): Jan.-March
Section
Original Article

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