Kidney dysfunction is associated with adverse outcomes in internal medicine COVID-19 hospitalized patients

OBJECTIVE: In this study, we aimed to evaluate the kidney involvement as-sessed by estimated glomerular filtration rate (eGFR), the associations with specific clinical disease variables and laboratory findings, and the predictive role of eGFR on clinical outcomes of patients admitted with COVID-19 in Internal Medicine ward in the first wave. PATIENTS AND METHODS: Clinical data of 162 consecutive patients hospitalized in the University Hospital Policlinico Umberto I in Rome, Italy, between December 2020 to May 2021 were collected and retrospectively analyzed. RESULTS: The median eGFR was significantly lower in patients with worse outcomes than in patients with favorable outcomes [56.64 ml/min/1.73 m2 (IQR 32.27-89.73) vs. 83.39 ml/min/1.73 m2 (IQR 69.59-97.08), p<0.001]. Patients with eGFR < 60 ml/ min/1.73 m(2) (n=38) were significantly older com-pared to patients with normal eGFR [82 years (IQR 74-90) vs. 61 years (IQR 53-74), p<0.001] and they had fever less frequently [39.5% vs. 64.2%, p<0.01]. Kaplan-Meier curves demonstrated that over-all survival was significantly shorter in patients with eGFR < 60 ml/min/1.73 m(2) (p<0.001). In mul-tivariate analysis, only eGFR < 60 ml/min/1.73 m2 [HR=2.915 (95% CI=1.110-7.659), p<0.05] and plate-let to lymphocyte ratio [HR=1.004 (95% CI=1.002-1.007), p<0.01] showed a significant predictive val-ue for death or transfer to intensive care unit (ICU). CONCLUSIONS: Kidney involvement on ad-mission was an independent predictor for death or transfer to ICU among hospitalized COVID-19 patients. The presence of chronic kidney dis-ease could be regarded as a relevant factor in risk stratification for COVID-19.