Epidemiology of Patients with CKD from Eastern North Carolina (ENC) Hospitalized with COVID-19

Background: Early meta-analysis by Jdiaa et al showed that patients with CKD were more likely to have worse outcomes from COVID–19 compared to patients with normal renal function. To our knowledge, a similar retrospective analysis of COVID-19 positive patients hospitalized in Eastern North Carolina has not been replicated. Our study aimed to describe demographics and compare outcomes of COVID-19 positive patients with and without baseline CKD hospitalized within the ECU Health System. Methods: This retrospective, observational study involved a review of data from electronic health records of patients aged > 18 years with laboratory-confirmed COVID-19 admitted to one of the ECU Health Systems from March to October 2020. We described patients’ demographics, comorbidities, length of stay, disposition, and mortality. We further subcategorized patients into two groups: those with glomerular filtration rate (GFR) > 60 ml/min/1.73 m2 and a second group with GFR < 60 ml/min/1.73 m2. Categorical variables were compared by Chi-squared while continuous variables were compared by Mann-Whitney U Test and reported as medians with interquartile ranges (IQR). The Institutional Review Board of ECU Health approved the study protocol before the study began. Results: Of the 446 hospitalized COVID-19 positive patients, the median age was 64.5 years, 49% were African American, followed by 30% Caucasians. 43% of the patients had underlying CKD at least stage IIIa and 6% had end-stage renal disease (ESRD) as per Kidney Disease Improving Global Outcomes (KDIGO) guidelines. The median BMI was 30 kg/m2 and 40% had tobacco exposure. Patients with GFR < 60 ml/min/1.73 m2 were mostly older > 70 years old, African-American (p-value <0.001), had underlying DM, HTN, and were more likely to be discharged to a skilled nursing facility (p-value <0.001). Patients who had GFR < 60 ml/min/1.73 m2 had a higher risk of in-hospital death compared to those with GFR> 60 ml/min/1.73 m2 (p-value <0.001). Conclusion: Our data demonstrated higher mortality rates in COVID-19 positive African-American patients with GFR < 60 ml/min/1.73 m2. It has been previously shown that ENC has a higher concentration of lower socioeconomic counties and an overall higher comorbidity index. Further data analysis is needed to determine if a GFR < 60 ml/min/1.73 m2 conveys an additional mortality risk outside the lower socioeconomic status.