Study Shows Effect of COVID-19 on Hospitalization Risk in CKD

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.