1. COVID-19 in CKD Patients : Lessons from 553 CKD Patients with Biopsy-Proven Kidney Disease
- Author
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María José Soler, Nestor Toapanta, Daniel Serón, Cinthia Baldallo, Irene Agraz, Clara García-Carro, Roxana Bury, Alejandra Gabaldon, Juan Carlos León Román, Ander Vergara, Irina B. Torres, Institut Català de la Salut, [Román JL, García-Carro C, Agraz I, Toapanta N, Torres I, Bury R, Baldallo C] Servei de Nefrologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Vergara A] Servei de Nefrologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Grup de Recerca en Nefrologia, Servei de Nefrologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Gabaldón A] Servei de Patologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Serón D, Soler MJ] Servei de Nefrologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Grup de Recerca en Nefrologia, Servei de Nefrologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Instituto Carlos IIIFEDER, Red de Investigación Renal (REDINREN), Madrid, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
Male ,Biopsy ,medicine.medical_treatment ,Disease ,Fetge - Càncer - Tractament ,Renin-Angiotensin System ,Hemoglobins ,Pulmonary Disease, Chronic Obstructive ,Chronic kidney disease ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,Risk of mortality ,Severe acute respiratory syndrome coronavirus 2 ,COVID-19 (Malaltia) - Complicacions ,Aged, 80 and over ,Kidney ,medicine.diagnostic_test ,Age Factors ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,Immunosuppression ,General Medicine ,Middle Aged ,Prognosis ,Hospitalization ,Renal Replacement Therapy ,medicine.anatomical_structure ,Cardiovascular Diseases ,Nephrology ,RL1-803 ,Hypertension ,Female ,Cardiology and Cardiovascular Medicine ,Research Article ,terapéutica::tratamiento de reemplazo renal [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,medicine.medical_specialty ,Dermatology ,Therapeutics::Renal Replacement Therapy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Internal medicine ,medicine ,Diseases of the circulatory (Cardiovascular) system ,Humans ,Renal replacement therapy ,Renal Insufficiency, Chronic ,Risk factor ,Aged ,Immunosuppression Therapy ,Fetge - Malalties - Biòpsia ,business.industry ,Male Urogenital Diseases::Urologic Diseases::Kidney Diseases [DISEASES] ,COVID-19 ,medicine.disease ,Diseases of the genitourinary system. Urology ,Coronavirus ,Biopsy-proven kidney disease ,RC666-701 ,RC870-923 ,business ,enfermedades urogenitales masculinas::enfermedades urológicas::enfermedades renales [ENFERMEDADES] ,Kidney disease - Abstract
Introduction: Chronic kidney disease (CKD) patients infected with COVID-19 are at risk of serious complications such as hospitalization and death. The prognosis and lethality of COVID-19 infection in patients with established kidney disease has not been widely studied. Methods: Data included patients who underwent kidney biopsy at the Vall d’Hebron Hospital between January 2013 and February 2020 with COVID-19 diagnosis during the period from March 1 to May 15, 2020. Results: Thirty-nine (7%) patients were diagnosed with COVID-19 infection. Mean age was 63 ± 15 years and 48.7% were male. Hypertension was present in 79.5%, CKD without renal replacement therapy in 76.9%, and cardiovascular disease in 64.1%. Nasopharyngeal swab was performed in 26 patients; older (p = 0.01), hypertensive (p = 0.005), and immunosuppressed (p = 0.01) patients, those using RAS-blocking drugs (p = 0.04), and those with gastrointestinal symptoms (p = 0.02) were more likely to be tested for COVID-19. Twenty-two patients required hospitalization and 15.4% died. In bivariate analysis, mortality was associated with older age (p = 0.03), cardiovascular disease (p = 0.05), chronic obstructive pulmonary disease (p = 0.05), and low hemoglobin levels (p = 0.006). Adjusted Cox regression showed that low hemoglobin levels at admission had 1.81 greater risk of mortality. Conclusions: Patients with COVID-19 infection and kidney disease confirmed by kidney biopsy presented a mortality of 15.4%. Swab test for COVID-19 was more likely to be performed in older, hypertensive, and immunosuppressed patients, those using RAS-blocking drugs, and those with gastrointestinal symptoms. Low hemoglobin is a risk factor for mortality.
- Published
- 2021