Renal Manifestations in Patients with COVID-19 Admitted to the Hospital

Objective: Renal manifestations in COVID-19 cases range from proteinuria to AKI, while COVID-19 mortality is linked to alveolar injury; renal involvement associates with diverse outcomes, including elevated mortality. The aim of this study was to compare COVID-19 infected patients with and without Chronic Kidney Disease (CKD), analyzing clinical and lab differences, acute kidney injury rates, and renal manifestations' impact on outcomes. Methods: This prospective cohort study was conducted across three COVID-19 centers: Al-Imamain Al-Kadhimain Medical City, Al-Karamu Hospital, and Dar Al-Salam Hospital, from January to July 2021. The cohort included 100 confirmed COVID-19 infected patients, followed until discharge, recovery, or death. Two groups were defined: Group A (CKD) with documented chronic kidney disease and COVID-19, and Group B (non-CKD) without prior renal disease. Data collection encompassed demographics, medical history, radiological and biochemical data, clinical renal indicators, COVID-19 severity, urine analysis, and development of AKI. Results: In this study involving 100 participants (33 CKD, 67 non-CKD), age differences were significant (p = 0.003), with CKD patients being older. COVID-19 severity and survival rates varied significantly (both p < 0.001) between study groups. Renal manifestations including proteinuria, hematuria, pyuria polyuria, oliguria, and anuria occurred more frequently in the CKD group but only proteinuria and oliguria reached statistical significance (p < 0.05). Male gender, proteinuria, hematuria, and AKI development were linked to heightened mortality risk. Lower hemoglobin, lymphocyte counts, and elevated D-dimer indicated CKD impact. Hypertension was significantly associated with AKI risk (p = 0.031). Conclusion: The study highlighted that age, male gender, and comorbidities like hypertension predicted COVID-19 severity and mortality. Renal indicators, notably proteinuria, hematuria, and AKI, were significant markers of increased mortality risk.