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COVID-19 in Patients with CKD in New York City.
Akchurin, Oleh; Meza, Kelly; Biswas, Sharmi; Greenbaum, Michaela; Licona-Freudenstein, Alexandra P; Goyal, Parag; Choi, Justin J; Choi, Mary E.
  • Akchurin O; Division of Pediatric Nephrology, Department of Pediatrics, Weill Cornell Medicine, New York, New York.
  • Meza K; New York Presbyterian Hospital, New York, New York.
  • Biswas S; Division of Pediatric Nephrology, Department of Pediatrics, Weill Cornell Medicine, New York, New York.
  • Greenbaum M; Division of Pediatric Nephrology, Department of Pediatrics, Weill Cornell Medicine, New York, New York.
  • Licona-Freudenstein AP; Division of Pediatric Nephrology, Department of Pediatrics, Weill Cornell Medicine, New York, New York.
  • Goyal P; New York Presbyterian Hospital, New York, New York.
  • Choi JJ; Division of Pediatric Nephrology, Department of Pediatrics, Weill Cornell Medicine, New York, New York.
  • Choi ME; New York Presbyterian Hospital, New York, New York.
Kidney360 ; 2(1): 63-70, 2021 Jan 28.
Article in English | MEDLINE | ID: covidwho-1102766
ABSTRACT

BACKGROUND:

COVID-19 has affected millions of people, and several chronic medical conditions appear to increase the risk of severe COVID-19. However, our understanding of COVID-19 outcomes in patients with CKD remains limited.

METHODS:

This was a retrospective cohort study of patients with and without CKD consecutively admitted with COVID-19 to three affiliated hospitals in New York City. Pre-COVID-19 CKD diagnoses were identified by billing codes and verified by manual chart review. In-hospital mortality was compared between patients with and without underlying CKD. Logistic regression was used to adjust this analysis for confounders and to identify patient characteristics associated with mortality.

RESULTS:

We identified 280 patients with CKD, and 4098 patients without CKD hospitalized with COVID-19. The median age of the CKD group was 75 (65-84) years, and age of the non-CKD group 62 (48-75) years. Baseline (pre-COVID-19) serum creatinine in patients with CKD was 1.5 (1.2-2.2) mg/dl. In-hospital mortality was 30% in patients with CKD versus 20% in patients without CKD (P<0.001). The risk of in-hospital death in patients with CKD remained higher than in patients without CKD after adjustment for comorbidities (hypertension, diabetes mellitus, asthma, and chronic obstructive pulmonary disease), adjusted OR 1.4 (95% CI,1.1 to 1.9), P=0.01. When stratified by age, elderly patients with CKD (age >70 years) had higher mortality than their age-matched control patients without CKD. In patients with CKD, factors associated with in-hospital mortality were age (adjusted OR, 1.09 [95% CI, 1.06 to 1.12]), P<0.001, baseline and admission serum phosphorus (adjusted OR, 1.5 [95% CI, 1.03 to 2.1], P=0.03 and 1.4 [95% CI, 1.1 to 1.7], P=0.001), serum creatinine on admission >0.3 mg/dl above the baseline (adjusted OR 2.6 [95% CI, 1.2 to 5.4]P=0.01), and diagnosis of acute on chronic kidney injury during hospitalization (adjusted OR 4.6 [95% CI, 2.3 to 8.9], P<0.001).

CONCLUSIONS:

CKD is an independent risk factor for COVID-19-associated in-hospital mortality in elderly patients. Acute-on-chronic kidney injury increases the odds of in-hospital mortality in patients with CKD hospitalized with COVID-19.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Renal Insufficiency, Chronic / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Humans / Middle aged Country/Region as subject: North America Language: English Journal: Kidney360 Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Renal Insufficiency, Chronic / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Humans / Middle aged Country/Region as subject: North America Language: English Journal: Kidney360 Year: 2021 Document Type: Article