Kidney Disease Leading Risk Factor For COVID-Related Hospitalization

An examination of Geisinger's electronic health records has revealed that chronic kidney disease is a leading risk factor for hospitalisation from COVID-19

An examination of Geisinger’s electronic health records has revealed that chronic kidney disease is a leading risk factor for hospitalisation from COVID-19. A team of Geisinger researchers studied the health records of 12,971 individuals who were tested for COVID-19 within the Geisinger system between March 7 and should 19. Of this group, 1,604 were COVID-positive, and 354 required hospitalisation.

The records were analyzed by the team for association between specific clinical conditions, including kidney, cardiovascular, respiratory, and metabolic conditions, and COVID-19 hospitalisation. Moreover, the chronic renal disorder was related to hospitalisation, and COVID-19 patients with end-stage renal disease were 11 times more likely to be admitted to the hospital than patients without kidney disease.

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Overall, chronic renal disorder was most strongly related to hospitalisation.  COVID-19 patients with end-stage renal disease were 11 times more likely to be admitted to the hospital than patients without kidney disease. The results were published in PLOS ONE.

“Previous studies have identified a spread of health conditions related to an increased risk of COVID-related hospitalisation, including diabetes, coronary failure , hypertension, and chronic renal disorder . What is significant here is that the magnitude of the kidney disease-related risk,” said Alex Chang, M.D., Geisinger nephrologist and co-director of Geisinger’s Kidney Health Research Institute.

“These findings highlight the necessity to stop COVID-19-related illness in patients with renal disorder and other high-risk conditions,” added Chang.

How underlying medical conditions increase the danger of COVID-19-related complications isn’t yet fully clear; however, the study suggests that the physiological stress caused by an excessive inflammatory response to COVID-19 infection could destabilise organs that are already weakened by chronic disease, or that organ injury from the virus could act as a “second-hit” to those organs.

“Consistent with this hypothesis, kidney and heart are among the tissues with the very best expression of ACE2, a SARS-CoV-2 receptor,” the team wrote. Geisinger’s resources as an integrated health system allowed for a fairly comprehensive analysis of available data while the sample size studied was relatively small.

Tooraj Mirshahi, the Ph.D., associate professor for Geisinger’s Department of Molecular and Functional Genomics said, “Our team used a novel approach made possible by our extensive electronic health records, unique demographic data and integrated health system.”

“We were ready to perform this study despite having a way lower number of COVID-19 cases compared to large hospitals in metropolitan areas,” added Mirshahi.

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