Since the very beginning of the COVID-19 pandemic, certain conditions have been associated with a higher risk of contracting the infection and also of the disease turning severe, requiring hospitalisation, admittance to intensive care units and death.
Studies have shown that older age or having conditions like high blood sugar, high blood pressure, heart disease and kidney disease can put you at higher risk of developing severe COVID-19 and mortality due to it.
A new study published in PLOS One suggests that of all these comorbidities, chronic kidney disease (CKD) is strongly associated with COVID-19 hospitalisation and adverse outcomes. In fact, the study indicates that this association is stronger than those found between other chronic conditions and COVID-19 infection.
COVID-19 and kidney disease
Previous studies have established a link between kidney diseases and COVID-19 severity. For example, a study published in Travel Medicine and Infectious Disease in September 2020 suggests that even though the involvement of kidneys in COVID-19 was considered to be negligible in the beginning, more recent data show a high prevalence of acute kidney injury (AKI) among COVID-19 patients.
The range of prevalence was thought to be just three to nine percent at the beginning of the pandemic but this study puts it at 15 percent among COVID-19 patients and up to 25 percent among critically-ill COVID-19 patients.
Another study published in Nature Reviews Nephrology in August 2020 included data from 17 million people in the UK and found that CKD is a key risk factor for COVID-19-related mortality.
This study urged nephrologists to ensure patient safety and recommended healthcare professionals to pay more attention to those with undiagnosed kidney problems.
The findings of the new study in PLOS One suggests the magnitude of the role of kidney disease in COVID-19 has been previously misunderstood, underlining the need for even more stringent diagnosis, treatment and care for COVID-19 patients with kidney diseases.
Chronic kidney disease and COVID-related hospitalisation
The new study, conducted by researchers at the Geisinger Health System, USA, used a cross-disease analytical approach. They collected data from electronic health records of patients found to be SARS-CoV-2 positive to identify associations between pre-existing health conditions and COVID-19 related hospitalisation.
The analysis included 12,971 patients who got tested for COVID-19 between March and May 2020 and had their underlying health issues, ranging from heart and respiratory diseases to kidney and metabolic conditions, diagnosed by January 2020.
Of these 12,971 patients, 1,604 were SARS-CoV-2 positive and 354 of these positive patients required hospitalisation.
The researchers then identified the major risk factors as indicated by underlying diseases in these 354 patients, and found that five disease categories had a significant link with COVID-19 related hospitalisation:
Six types of kidney diseases, including CKD, end-stage renal disease, stage III CKD and acute renal failure.
Six types of cardiovascular disease, including nonhypertensive congestive heart failure and peripheral vascular disease.
Three metabolic diseases, including type 2 diabetes.
Five respiratory diseases, including chronic airway obstruction, pneumonia and chronic bronchitis.
A single association with anaemia of chronic disease, the type of anaemia that affects people with autoimmune diseases, cancer and CKD.
The researchers not only found CKD had the strongest quantifiable association with COVID-19 related hospitalisation but also revealed that people with pre-existing stage IV CKD, stage V CKD or dialysis and those who'd had a kidney transplant were more likely to have adverse outcomes after hospitalisation.
The findings of this study indicate an urgent need to prevent COVID-19 infection in patients with kidney disease.
For more information, read our article on COVID-19 prevention tips for older people with chronic illnesses.
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