ABSTRACT
Background: COVID-19 infection, an acute respiratory syndrome caused by coronavirus, has recently emerged as a lethal pandemic. Many elderly patients have chronic kidney disease and several other comorbidities that are associated with worse outcomes. We hypothesized chronic kidney disease (CKD) in elderly patients is an independent risk of mortality and more severe COVID-19, even after adjustment for comorbidities. Methods: This is a retrospective study, which enrolled 120 patients attended in a tertiary academic hospital divided into 2 groups, CKD (N=58) and non-CKD (N=62), according to eGFG < or ≥ 45ml/min/1.73m2. Charlson Comorbidity Index was used to evaluate comorbidities. Results: Patients with CKD have a significantly (all p values <0.05) higher leucocytes count, C-reactive protein, troponin, and lactate dehydrogenase;they also presented lower albumin. There was no difference in body mass index (BMI), lymphocytes, hemoglobin, age, gender, Charlson Comorbidity Index, or duration of symptoms between groups. Patients with CKD presented more severe COVID-19, as evidenced by a higher inspiratory oxygen fraction (p=0.001), major radiological findings in computed tomography, groundglass opacity (25% non-CKD and 53.1% CKD group presented lesion in >75% lung, p=0.042), and higher mortality (40.3% non-CKD vs. 75.9% CKD, p=0.0001). Logistic linear regression has revealed that CKD (RR 5.4, p=0.0001) was independent associated with mortality after adjustment for Charlson comorbidity Index (RR 1.2, p=0.034), age (p=0.551), gender (p=0.820) and BMI (p=0.941). Conclusions: Elderly patients with CKD have a higher and independent risk for mortality after COVID-19. These patients should be closely monitored during this pandemic situation in order to avoid further damage.