Patients with COVID-19 and end-stage renal disease were 11 times more likely to be admitted to the hospital than patients without kidney disease.
An analysis of Geisinger's electronic health records shows how chronic kidney disease (CKD) is leading risk factor for hospitalization from coronavirus disease 2019 (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 May 19. Of this group, 1604 were COVID-positive and 354 required hospitalization. The team analyzed the records for association between specific clinical conditions, including kidney, cardiovascular, respiratory and metabolic conditions, and COVID-19 hospitalization.
Overall, CKD was most strongly associated with hospitalization, 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.
The results were published in PLOS ONE.
"Previous studies have identified a variety of health conditions associated with an increased risk of COVID-related hospitalization, including diabetes, heart failure, hypertension, and chronic kidney disease. What is significant here is the magnitude of the kidney disease-related risk," Alex Chang, MD, Geisinger nephrologist and co-director of Geisinger's Kidney Health Research Institute, said in a statement. "These findings highlight the need to prevent COVID-19-related illness in patients with kidney disease and other high-risk conditions."
How underlying medical conditions increase the risk of COVID-19-related complications is not yet fully clear; however, the study suggests that the physiological stress caused by an excessive inflammatory response to COVID-19 infection could destabilize organs already weakened by chronic disease, or that organ injury from the virus could act as a "second-hit" to these organs.
"Consistent with this hypothesis, kidney and heart are among the tissues with the highest expression of ACE2, a SARS-CoV-2 receptor," the team wrote.