Abstract
Nephrology Referral Pattern and Short-Term Outcomes in COVID-19 Positive Patients
Introduction: Coronavirus disease is considered a pandemic by the WHO. Studies which have described the pattern and outcomes of kidney disease in COVID patients are scarce. Kidney involvement can be a decisive factor which can lead to negative outcomes in these patients.
Aim: To study the clinical presentation, laboratory profile and short-term outcomes of COVID patients who already have or who newly develop kidney disease.
Materials and Methods: All COVID-19 positive patients who sought nephrology referral were included in the study. Laboratory parameters were measured serially during the admitted period and at discharge or before death.
Results: Among a total of 885 patients, 38.2% (n=338) were previously diagnosed Chronic Kidney Disease (CKD) patients of which 45.9% (n=155) were Chronic Kidney Disease Stage 5 on Dialysis (CKD 5D) and 5.5% (n=50) were Kidney Transplant Recipients (KTR). Acute deterioration of renal function was noted in 83.6%, with 9.3% warranting renal replacement therapy. There was a significant difference (p=0.002) in death rates between COVID waves 1 and 2 (16.1% vs. 25.4%). Mortality was highest among the CKD 5D patients (31.3%) followed by KTR (28.6%) followed by CKD ND (Non-Dialysis). Hypotension at admission (p=0.00), dialysis-requiring renal failure (p<0.05) and requirement for mechanical ventilation (p=0.00) were factors which predicted higher mortality. In 18.1% of patients (n=159), baseline CKD was detected for the first-time during hospitalisation.
Conclusion: Among the COVID patients, mortality was higher in those patients who had kidney disease (especially CKD 5D and KTR). Compared to the first wave, second COVID wave had higher mortality.
Author(s): Gokul Prasannan
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