COVID-19 and kidney: risk, damage and consequences
Keywords:
COVID-19, chronic kidney disease, chronic inflammation, comorbidities, prevalenceAbstract
Introductions: Chronic kidney disease is the most prevalent risk factor for the severity of COVID-19.
Objective: To demonstrate acute and chronic kidney damage in patients who died of COVID-19 and to identify chronic kidney damage in post-COVID-19 discharged patients.
Methods: It was conducted a study on renal tissue samples from 85 deceased patients and a clinical study with a sample (92 patients) of the 197 patients discharged between April and June of the year 2020 from the Dr. Salvador Allende Hospital in Havana at (6, 12 and 24) months after the hospital release. Patients completed a clinical questionnaire and underwent kidney ultrasound, as well as qualitative urine, hemochemistry, hematology, histopathology and tubular function tests.
Results: The histopathologic study of the 85 deceased patients showed that 31 (36.47%) had prior chronic kidney damage; only seven deceased patients (8.2%) had a chronic kidney disease diagnosis. Positive inflammation markers. At (6, 12 and 24) months: ferritin: (15.2%; 2.2%; 19%); c-reactive protein: (25%; 22%; 29.1%); neutrophil-to-lymphocyte ratio >3: (0%; 21%; 27.8%); platelet-to-lymphocyte ratio: (23.9%; 62.2%; 68.4%), cystatin c (64.1%; 64.4%; 43%).
Positive kidney damage markers. At (6, 12 and 24) months: protein-to-creatinine ratio: (16.3%; 7.8%; 7.6 %), albumin-to-creatinine ratio: (3.3%; 8.9%; 25.3 %). creatinine: (2.2%; 4.4 %; 7.6 %), cystatin C: (64.1%; 64.4%; 43%).
Chronic kidney disease prevalence: 6 months 20 (21.7%), 12 months16 (17.7%) y 24 months 22 (27.8%).
Conclusions: Post-COVID-19 chronic kidney disease prevalence is very high and is associated with chronic inflammation.
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