Patients with COVID-19 and end-stage kidney disease were 11 times more likely to be hospitalized than those without kidney disease.
An analysis of Geisinger’s electronic patient records shows that chronic kidney disease (CKD) is the main risk factor for hospital stays due to Coronavirus Disease 2019 (COVID-19).
A team of Geisinger researchers examined the health records of 12,971 people who were tested for COVID-19 in the Geisinger system between March 7 and May 19. Of this group, 1604 were COVID positive and 354 had to be hospitalized. The team analyzed the records for associations between specific clinical conditions, including kidney, cardiovascular, respiratory and metabolic conditions, and COVID-19 hospitalizations.
Overall, CKD was most strongly associated with hospitalizations, and COVID-19 patients with end-stage kidney disease were 11 times more likely to be hospitalized than those without kidney disease.
The results were published in PLOS ONE.
“Previous studies have identified a variety of health conditions associated with an increased risk of COVID-related hospitalization, including diabetes, heart failure, high blood pressure, and chronic kidney disease. What matters here is the level of risk associated with kidney disease.” Alex Chang, MD, Geisinger nephrologist and co-director of the Geisinger Institute for Kidney Health Research, said in a statement. “These results underscore the need to prevent COVID-19-related illness in patients with kidney disease and other high-risk conditions.”
How the underlying medical conditions increase the risk of complications related to COVID-19 is not yet fully understood. However, the study suggests that the physiological stress caused by an excessive inflammatory response to COVID-19 infection could destabilize organs already weakened by chronic illness, or that organ injury from the virus could be seen as a “second hit” could work for these organs.
“Consistent with this hypothesis, the kidney and heart are among the tissues with the highest expression of ACE2, a SARS-CoV-2 receptor,” the team wrote.