Renal impairment in patients admitted due to COVID-19 — the experience of University Hospital No 1 in Bydgoszcz

Introduction: COVID-19 is a prominently respiratory infection, with potential renal complications. Our objective was to describe the incidence of renal impairment and its influence on clinical outcome in patients admitted to University Hospital No 1 in Bydgoszcz due to COVID-19.Material and methods: In this single-center observational study we retrospectively identified patientswith a positive test result for SARS-CoV-2 from either a nasopharyngeal or oropharyngeal swab PCR (n = 988) who were admitted to University Hospital No 1 in Bydgoszcz, Poland since April 1, 2020 to April 30, 2021. Details of the patients’ demographics, diagnoses (based on ICD-10 codes), eGFR and clinical outcomes were obtained using a combination of a manual chart review of the electronic medical record from the hospital database.Results: Median baseline eGFR was 77,4 ml/min (IQR 51,6–93,7 ml/min) and minimal eGFR was 68,7 ml/min (IQR 39,9–90 ml/min), p < 0,05. We found significant differences in median baseline and minimal eGFR between patients discharged and deceased (80,8 vs. 55,4 ml/min and 73,7 vs. 33 ml/min, respectively, p < 0,001). Patients who died (12,5 %) were older, with more co-morbidities including CKD and AKI, and presented a significantly lower value of eGFR both at baseline and during hospital stay, as well as, more frequent and extensive deterioration of eGFR. Factors predisposing to in-hospital death were age, atrial fibrillation, heart failure, coronary artery disease, and among them AKI and CKD were strong negative prognostic parameters.Conclusions: Renal impairment on admission as well as during hospitalization among patients with SARS-CoV-2 infection is a risk factor of negative outcome

Clinical Characteristics and Predictors of In-Hospital Mortality of Patients Hospitalized with COVID-19 Infection

Background: The identification of parameters that would serve as predictors of prognosis in COVID-19 patients is very important. In this study, we assessed independent factors of in-hospital mortality of COVID-19 patients during the second wave of the pandemic. Material and methods: The study group consisted of patients admitted to two hospitals and diagnosed with COVID-19 between October 2020 and May 2021. Clinical and demographic features, the presence of comorbidities, laboratory parameters, and radiological findings at admission were recorded. The relationship of these parameters with in-hospital mortality was evaluated. Results: A total of 1040 COVID-19 patients (553 men and 487 women) qualified for the study. The in-hospital mortality rate was 26% across all patients. In multiple logistic regression analysis, age ≥ 70 years with OR = 7.8 (95% CI 3.17–19.32), p p = 0.004, the presence of typical COVID-19-related lung abnormalities visualized in chest computed tomography ≥40% with OR = 2.5 (95% CI 1.05–6.23), p = 0.037, and a concomitant diagnosis of coronary artery disease with OR = 3.5 (95% CI 1.38–9.10), p = 0.009 were evaluated as independent risk factors for in-hospital mortality. Conclusion: The relationship between clinical and laboratory markers, as well as the advancement of lung involvement by typical COVID-19-related abnormalities in computed tomography of the chest, and mortality is very important for the prognosis of these patients and the determination of treatment strategies during the COVID-19 pandemic