Kidney impairment is associated with in-hospital death of COVID-19 patients

Yichun Cheng; Ran Luo; Kun Wang; Meng Zhang; Zhixiang Wang; Lei Dong; Junhua Li; Ying Yao; Shuwang Ge; Gang Xu

In our study, a lot of patients have kidney impairment, including abnormal urinary analysis (proteinuria, hematuria) and kidney dysfunction (elevated BUN and Scr) on admission. Indeed, multiple organ involvements including the liver, gastrointestinal tract and kidney have been reported during the course of SARS in 2003 8 and COVID-19 9 . Of note, the high prevalence of kidney impairment at baseline may be explained by the fact that many COVID-19 patients couldn't be admitted to hospital in the early stage of disease outbreak because of large number of patients and limited beds in hospital in Wuhan. In addition, another explanation is that some COVID-19 patients may have a past history of chronic kidney disease (CKD) and CKD patients have a proinflammatory milieu and functional defects in innate and adaptive immune cell populations 10 . In a community-based cohort of nearly 10,000 adult individuals, reduced eGFR and elevated albumin creatinine ratio were associated with higher risk for hospitalization with infection and subsequent mortality 11 . Furthermore, CKD patients have a higher risk for upper respiratory tract infection 12 and pneumonia 13 .