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Early kidney injury predicts disease progression in patients with COVID-19: a cohort study

Tingting Xia1, Wenjing Zhang2, Yu Xu2

  • 1Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), NO.30 Gaotanyan Street, Chongqing, 400038, People's Republic of China.

BMC Infectious Diseases
|September 28, 2021
PubMed
Abstract

Insights

Kidney injury is common in COVID-19 patients, with many showing reduced kidney function upon admission. Early detection of kidney damage can help identify patients at higher risk of severe disease progression.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Virology

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) utilizes angiotensin-converting enzyme 2 (ACE2) as its receptor.
  • ACE2 is more prevalent in kidney tissue than lung tissue, indicating the kidney as a potential target organ for SARS-CoV-2.
  • Limited understanding exists regarding the specific kidney injuries caused by Coronavirus Disease 2019 (COVID-19).

Purpose of the Study:

  • To investigate the association between kidney injury and disease progression in patients diagnosed with COVID-19.
  • To identify early indicators of kidney dysfunction that correlate with COVID-19 severity.

Main Methods:

  • A retrospective cohort study involving 2630 COVID-19 patients from Huoshenshan Hospital, Wuhan, China.
  • Extraction of kidney function indexes and clinical data from electronic medical records.
  • Analysis of associations using Cox proportional-hazards regression and generalized linear mixed models.

Main Results:

  • 22.0% of patients experienced decreased estimated glomerular filtration rate (eGFR), and 24.0% had reduced creatinine clearance (Ccr).
  • Proteinuria (15.0%) and hematuria (8.1%) were observed in a significant proportion of patients.
  • Hematuria, proteinuria, elevated baseline serum creatinine and blood urea nitrogen, and decreased baseline eGFR were independent risk factors for disease progression.

Conclusions:

  • A high incidence of early kidney function impairment was noted in COVID-19 patients upon hospital admission.
  • Identifying early kidney injury can assist clinicians in predicting poor prognosis among COVID-19 patients.
  • Monitoring kidney function is crucial for managing COVID-19 patients and assessing their risk of progression.
Keywords:
Coronavirus disease 2019Disease progressionKidney injurySevere respiratory syndrome coronavirus 2

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