Impact of Kidney Failure on the Severity of COVID-19

Zarębska-Michaluk, Dorota; Jaroszewicz, Jerzy; Rogalska, Magdalena; Lorenc, Beata; Rorat, Marta; Szymanek-Pasternak, Anna; Piekarska, Anna; Berkan-Kawińska, Aleksandra; Sikorska, Katarzyna; Tudrujek-Zdunek, Magdalena; Oczko-Grzesik, Barbara; Bolewska, Beata; Czupryna, Piotr; Kozielewicz, Dorota; Kowalska, Justyna; Podlasin, Regina; Kłos, Krzysztof; Mazur, Włodzimierz; Leszczyński, Piotr; Szetela, Bartosz; Reczko, Katarzyna; Flisiak, Robert

Background: Patients with kidney failure are at an increased risk of progression to a severe form of coronavirus disease 2019 (COVID-19) with high mortality. The current analysis was aimed to assess the impact of renal failure on the severity of COVID-19 and identify the risk factors of the fatal outcome in this population. Methods: The analysis included patients from the SARSTer database, a national real-world study evaluating treatment for COVID-19 in 30 Polish centers. Data were completed retrospectively and submitted online. Results: A total of 2322 patients were included in the analysis. Kidney failure was diagnosed in 455 individuals (19.65%), of whom 373 presented moderate stage and 82 patients, including 14 dialysis individuals, presented severe renal failure. Patients with kidney failure were significantly older and demonstrated a more severe course of COVID-19. The age, baseline SpO(2), the ordinal scale of 4 and 5, neutrophil and platelet count, estimated glomerular filtration rate, and C-reactive protein concentration as well as malignancy and arterial hypertension were the independent predictors of 28-day mortality in logistic regression analysis. Conclusions: Underlying kidney disease in patients with COVID-19 is among the leading factors associated with a higher risk of severe clinical presentation and increased mortality rate.