Background: The clinical course of COVID-19 is more severe in elderly patients with cardio-metabolic co-morbidities. Chronic kidney disease is considered an independent cardiovascular risk factor. We aimed to evaluate the impact of reduced eGFR on the composite outcome of admission to ICU and death in a sample of consecutive COVID-19 hospitalized patients. Methods: We retrospectively evaluated clinical records of a consecutive sample of hospitalized COVID-19 patients. A total of 231 patients were considered for statistical analysis. The whole sample was divided in two groups on the basis of eGFR value, e.g., ≥ or <60 mL/min/1.73 m 2 . Patients with low eGFR were further divided among those with a history of chronic kidney disease (CKD) and those without (AKI, acute kidney injury). The primary outcome was a composite of admission to ICU or death, whichever occurred first. The single components were secondary outcomes. Results: Seventy-nine (34.2%) patients reached the composite outcome. A total of 64 patients (27.7%) died during hospitalization, and 41 (17.7%) were admitted to the ICU. A significantly higher number of events was present among patients with low eGFR ( p < 0.0001). Age ( p < 0.001), SpO2 ( p < 0.001), previous anti-platelet treatment ( p = 0.006), Charlson’s Comorbidities Index ( p < 0.001), serum creatinine ( p < 0.001), eGFR ( p = 0.003), low eGFR ( p < 0.001), blood glucose levels ( p < 0.001), and LDH ( p = 0.003) were significantly associated with the main outcome in univariate analysis. Low eGFR (HR 1.64, 95% CI 1.02–2.63, p = 0.040) and age (HR per 5 years 1.22, 95% CI 1.10–1.36, p < 0.001) were significantly and independently associated with the main outcome in the multivariate model. Patients with AKI showed an increased hazard ratio to reach the combined outcome ( p = 0.059), while those patients with both CKD had a significantly higher probability of developing the combined outcome ( p < 0.001). Conclusions: Patients with reduced eGFR at admission should be considered at high risk for clinical deterioration and death, requiring the best supportive treatment in order to prevent the worst outcome.
【저자키워드】 Respiratory failure, Chronic kidney disease, glomerular filtration rate, cardiovascular comorbidities, 【초록키워드】 COVID-19, Hospitalization, LDH, Acute kidney injury, outcome, hospitalized patients, ICU, Probability, Clinical course, AKI, cardiovascular risk, Patient, death, Kidney disease, age, Admission, co-morbidities, blood glucose, statistical analysis, Elderly patient, Clinical deterioration, CKD, high risk, chronic, index, serum creatinine, Supportive treatment, Primary outcome, hospitalized COVID-19 patients, SpO2, 95% CI, Secondary outcomes, hazard ratio, multivariate model, whole sample, component, Univariate analysis, Prevent, event, independent, consecutive sample, evaluate, occurred, died, significantly, evaluated, reduced, significantly higher, reached, two group, anti-platelet treatment, 【제목키워드】 COVID-19, Strong,