Impact of renal function on admission in COVID-19 patients: an analysis of the international HOPE COVID-19 (Health Outcome Predictive Evaluation for COVID 19) Registry.

Abstract

BACKGROUND:

Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite its international aggressive extension, with a significant morbidity and mortality, the impact of renal function on its prognosis is uncertain.

METHODS:

Analysis from the international HOPE-Registry (NCT04334291). The objective was to evaluate the association between kidney failure severity on admission with the mortality of patients with SARS-CoV-2 infection. Patients were categorized in 3 groups according to the estimated glomerular filtration rate on admission (eGFR > 60 mL/min/1.73 m2, eGFR 30-60 mL/min/1.73 m2 and eGFR < 30 mL/min/1.73 m2).

RESULTS:

758 patients were included: mean age was 66 ± 18 years, and 58.6% of patient were male. Only 8.5% of patients had a history of chronic kidney disease (CKD); however, 30% of patients had kidney dysfunction upon admission (eGFR < 60 mL/min/1.73 m2). These patients received less frequently pharmacological treatment with hydroxychloroquine or antivirals and had a greater number of complications such as sepsis (11.9% vs 26.4% vs 40.8%, p < 0.001) and respiratory failure (35.4% vs 72.2% vs 62.0%, p < 0.001) as well as a higher in-hospital mortality rate (eGFR > 60 vs eGFR 30-60 vs and eGFR < 30, 18.4% vs 56.5% vs 65.5%, p < 0.001). In multivariate analysis: age, hypertension, renal function, 02 saturation < 92% and lactate dehydrogenase elevation on admission independently predicted all-cause mortality.

CONCLUSIONS:

Renal failure on admission in patients with SARS-CoV-2 infection is frequent and is associated with a greater number of complications and in-hospital mortality. Our data comes from a multicenter registry and therefore does not allow to have a precise mortality risk assessment. More studies are needed to confirm these findings.

• Authors: Aitor Uribarri, Iván J Núñez-Gil, Alvaro Aparisi, Victor M Becerra-Muñoz, Gisela Feltes, Daniela Trabattoni, Inmaculada Fernández-Rozas, María C Viana-Llamas, Martino Pepe, Enrico Cerrato, Thamar Capel-Astrua, Rodolfo Romero, Alex F Castro-Mejía, Ibrahim El-Battrawy, Javier López-País, Fabrizio D'Ascenzo, Oscar Fabregat-Andres, Alfredo Bardají, Sergio Raposeiras-Roubin, Francisco Marín, Antonio Fernández-Ortiz, Carlos Macaya, Vicente Estrada, HOPE COVID-19 Investigators
• Journal: Journal of nephrology (J Nephrol) Vol. 33 Issue 4 Pg. 737-745 (08 2020) ISSN: 1724-6059 [Electronic] Italy
• PMID: 32602006 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Peptidyl-Dipeptidase A
• ACE2 protein, human
• Angiotensin-Converting Enzyme 2

Topics

• Acute Kidney Injury (epidemiology)
• Aged
• Aged, 80 and over
• Angiotensin-Converting Enzyme 2
• Betacoronavirus
• COVID-19
• Coronavirus Infections (epidemiology, mortality, physiopathology, therapy)
• Female
• Glomerular Filtration Rate (physiology)
• Humans
• Male
• Middle Aged
• Pandemics
• Peptidyl-Dipeptidase A (physiology)
• Pneumonia, Viral (epidemiology, mortality, physiopathology, therapy)
• Registries
• Risk Assessment
• SARS-CoV-2