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Frequency of deranged renal profile in patients with COVID-19: Tertiary Care Experience from a developing country
Muhammad Sohaib Asghar1, Muhammad Nadeem Ahsan2, Mohammed Akram3
1Department of Internal Medicine, Dow University Hospital, Dow University of Health Sciences, Karachi, Pakistan.
Insights
COVID-19 patients with kidney problems, including elevated urea and creatinine, face higher risks of intensive care unit (ICU) admission and death. Monitoring renal function is crucial for managing severe cases.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease-2019 (COVID-19) is a global pandemic.
- Kidney derangements are a potential complication of COVID-19.
Purpose of the Study:
- To evaluate renal derangements in COVID-19 patients in Pakistan.
- To assess the association between renal function and outcomes like ICU admission and mortality.
Main Methods:
- Retrospective, observational study of 362 admitted COVID-19 patients.
- Evaluation of renal profiles (urea, creatinine, eGFR) at admission and during hospital stay.
- Statistical analysis including hazard ratios and Kaplan-Meier plots.
Main Results:
- Renal profiles were deranged in nearly half of ICU admissions and mortalities, increasing to two-thirds during hospitalization.
- Approximately 80% of deaths had elevated urea and creatinine.
- Non-survivors showed a significant decline in estimated glomerular filtration rate (eGFR), while survivors showed a mean increase.
- Elevated serum urea and creatinine levels were significantly associated with mortality.
Conclusions:
- Deranged renal function in COVID-19 patients is linked to increased ICU admissions and mortality.
- Close monitoring of kidney function is essential for predicting and managing COVID-19 outcomes.
- Early detection and management of renal complications may improve patient survival.
Abstract:
Coronavirus disease-2019 (COVID-19) is a global pandemic, also affecting Pakistan with its first case reported on February 26, 2020. Since then, it has been declared a pandemic by the World Health Organization. Our study aimed to evaluate the renal derangements associated with COVID-19 infection in our population. A retrospective, observational study was conducted to include all the admitted patients having COVID-19 positive, and evaluated those for derangements of renal function (n = 362). Out of the 362 patients, 229were admitted in the ward, 133 were in intensive care unit (ICU), 258 of them recovered, while 104 deaths reported. At admission, the renal profile was deranged in almost one-half of ICU admissions and mortalities which increased to two-third during the hospital stay, with around 80% of deaths reported with increased urea and creatinine levels. Among the deceased patients, around one-third of the mortalities developed renal profile derangements during the hospital stay although they were admitted with a normal renal profile. An estimated glomerular filtration rate showed a mean increase of 13.37 mL/min/1.73 m2 during the hospital stay of surviving patients, while a decline of 19.92 in nonsurviving patients. A hazard ratio of 3.293 (P <0.001) for admitting serum urea and 3.795 (P = 0.009) at discharge and for serum creatinine at 5.392 (P <0.001) on discharge was associated significantly with mortality. Kaplan-Meier plot showed a significant decline in days of survival with deranged urea and creatinine (P <0.001). The deranged renal function in COVID-19 patients is associated with an increased number of ICU admissions as well as mortalities.
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