Mortality rate and associated risk factors in hospitalised COVID-19 patients with kidney disease

ABSTRACT

Introduction: COVID-19 still poses a high morbidity and mortality in chronic kidney disease. We aim to determine the risk factors for mortality amongst hospitalised COVID-19 patients with kidney disease. Material(s) and Method(s) This is an observational cohort study involving all COVID-19 patients with kidney disease in the first quarter of 2021. Relevant data was extracted from the electronic medical records and statistical analysis was conducted using SPSS version 26. Result(s) Of 414 COVID-19 patients, 165 (39.9%) had kidney disease [25.5% end stage kidney disease (ESKD), 4.2% chronic kidney disease (CKD) and 70.3% acute kidney injury (AKI)). 56 of them died, giving an inpatient mortality rate of 33.9% in patients with kidney disease compared to 17.1% from all COVID-19 admissions. ESKD had the highest mortality rate at 42.9% followed by AKI, 31% and CKD, 28.6% (p=0.365). Majority of patients with kidney disease who died, were older (66 +/- 10.4 vs 54 +/- 14.6, p<0.001), male (78.6% vs 61.5%, p=0.035) and had category 5 infection (28.6% vs 19.3%;p=0.009). 66.1% were on mechanical ventilation while 51.8% were managed in the intensive care unit. Multiple logistic regression predicted older age, premorbid CKD & ESKD, raised peak serum sodium, admission category of illness 4 & 5, mechanical ventilation and unknown epidemiology link to increase mortality risk in patients with COVID-19 infection with kidney disease. Conclusion(s) COVID-19 mortality rate remains high amongst those with ESKD, CKD and AKI. Future studies should evaluate the incidence and outcome post vaccination.