Renal Manifestation of COVID-19 and its Association with Severity of Disease in a Tertiary Care Hospital of South India

Abstract

Objective: Kidney manifestation of coronavirus disease-2019 ranges from proteinuria and hematuria to acute kidney injury. The occurrence of acute kidney injury ranges from 0.5% to 80% across various studies. This study was conducted to know the kidney manifestation of coronavirus disease-2019 in the south Indian population and its association with severity of disease. Methods: This is a retrospective cohort study that assessed coronavirus disease-2019-positive patients admitted from September 1, 2020, to October 31, 2020. Data were collected by accessing electronic medical records. Proteinuria and hematuria were assessed by dipstick. Lab data including serum creatinine were noted. Creatinine on 7 ± 2, 14 ± 4, and 45 ± 15 (after discharge) days was captured. Descriptive analysis was done in frequency and proportions for categorical variables and mean and standard deviation for continuous variables. Chi-square test was used to compare kidney manifestations based on the severity of coronavirus disease-2019. Kruskal–Wallis and Mann–Whitney tests were used to compare mean values of different inflammatory markers and severity of coronavirus disease-2019, acute kidney injury, proteinuria, and hematuria. Results: A total of 1561 patients admitted during the study period were screened. After exclusion criteria, 426 patients were enrolled. The occurrence of acute kidney injury was 14.8%. Proteinuria was seen in 75 patients (17.6%) and hematuria in 39 patients (9.15 %);47.5% of patients with acute kidney injury, 45.9 % with proteinuria, and 34.4 % with hematuria had severe coronavirus disease-2019 illness. The recovery of acute kidney injury at a mean duration of 45 ± 15 days post-discharge was 83.63 %. Conclusion: Kidney involvement is not uncommon in patients with coronavirus disease-2019. The presence of acute kidney injury, proteinuria, and/or hematuria is associated with increased mortality among patients hospitalized with coronavirus disease-2019. © 2022 Turkish Society of Nephrology. All rights reserved.