tetano
Editor, Senior Moderator
J Nephrol
. 2020 Jun 29.
doi: 10.1007/s40620-020-00790-5. Online ahead of print.
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
Aitor Uribarri[SUP] 1 [/SUP], Iv?n J N??ez-Gil[SUP] 2 [/SUP], Alvaro Aparisi[SUP] 3 [/SUP], Victor M Becerra-Mu?oz[SUP] 4 [/SUP], Gisela Feltes[SUP] 5 [/SUP], Daniela Trabattoni[SUP] 6 [/SUP], Inmaculada Fern?ndez-Rozas[SUP] 7 [/SUP], Mar?a C Viana-Llamas[SUP] 8 [/SUP], Martino Pepe[SUP] 9 [/SUP], Enrico Cerrato[SUP] 10 [/SUP], Thamar Capel-Astrua[SUP] 11 [/SUP], Rodolfo Romero[SUP] 12 [/SUP], Alex F Castro-Mej?a[SUP] 13 [/SUP], Ibrahim El-Battrawy[SUP] 14 15 [/SUP], Javier L?pez-Pa?s[SUP] 16 [/SUP], Fabrizio D'Ascenzo[SUP] 17 [/SUP], Oscar Fabregat-Andres[SUP] 18 [/SUP], Alfredo Bardaj?[SUP] 19 [/SUP], Sergio Raposeiras-Roubin[SUP] 20 [/SUP], Francisco Mar?n[SUP] 21 [/SUP], Antonio Fern?ndez-Ortiz[SUP] 2 [/SUP], Carlos Macaya[SUP] 2 [/SUP], Vicente Estrada[SUP] 2 [/SUP], HOPE COVID-19 Investigators
AffiliationsExpand
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 m[SUP]2[/SUP], eGFR 30-60 mL/min/1.73 m[SUP]2[/SUP] and eGFR < 30 mL/min/1.73 m[SUP]2[/SUP]).
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 m[SUP]2[/SUP]). 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, 0[SUP]2[/SUP] 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.
Keywords: Acute kidney injury; COVID-19; Chronic kidney failure; Mortality; Prognosis; Registry.
. 2020 Jun 29.
doi: 10.1007/s40620-020-00790-5. Online ahead of print.
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
Aitor Uribarri[SUP] 1 [/SUP], Iv?n J N??ez-Gil[SUP] 2 [/SUP], Alvaro Aparisi[SUP] 3 [/SUP], Victor M Becerra-Mu?oz[SUP] 4 [/SUP], Gisela Feltes[SUP] 5 [/SUP], Daniela Trabattoni[SUP] 6 [/SUP], Inmaculada Fern?ndez-Rozas[SUP] 7 [/SUP], Mar?a C Viana-Llamas[SUP] 8 [/SUP], Martino Pepe[SUP] 9 [/SUP], Enrico Cerrato[SUP] 10 [/SUP], Thamar Capel-Astrua[SUP] 11 [/SUP], Rodolfo Romero[SUP] 12 [/SUP], Alex F Castro-Mej?a[SUP] 13 [/SUP], Ibrahim El-Battrawy[SUP] 14 15 [/SUP], Javier L?pez-Pa?s[SUP] 16 [/SUP], Fabrizio D'Ascenzo[SUP] 17 [/SUP], Oscar Fabregat-Andres[SUP] 18 [/SUP], Alfredo Bardaj?[SUP] 19 [/SUP], Sergio Raposeiras-Roubin[SUP] 20 [/SUP], Francisco Mar?n[SUP] 21 [/SUP], Antonio Fern?ndez-Ortiz[SUP] 2 [/SUP], Carlos Macaya[SUP] 2 [/SUP], Vicente Estrada[SUP] 2 [/SUP], HOPE COVID-19 Investigators
AffiliationsExpand
- PMID: 32602006
- DOI: 10.1007/s40620-020-00790-5
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 m[SUP]2[/SUP], eGFR 30-60 mL/min/1.73 m[SUP]2[/SUP] and eGFR < 30 mL/min/1.73 m[SUP]2[/SUP]).
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 m[SUP]2[/SUP]). 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, 0[SUP]2[/SUP] 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.
Keywords: Acute kidney injury; COVID-19; Chronic kidney failure; Mortality; Prognosis; Registry.