Open AccessCOVID-19 in Patients with CKD in New York City
Author(s) -
Oleh Akchurin,
Kelly Meza,
Sharmi Biswas,
Michaela Greenbaum,
Alexandra P. Licona-Freudenstein,
Parag Goyal,
Justin Choi,
Mary E. Choi
Publication year - 2021
Publication title -
kidney360
Language(s) - English
Resource type - Journals
ISSN - 2641-7650
DOI - 10.34067/kid.0004142020
Subject(s) - medicine , kidney disease , diabetes mellitus , retrospective cohort study , logistic regression , confounding , intensive care medicine , endocrinology
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 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 0.3 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.