@article{Carter_B-2022_63911,
title = {Prognostic value of estimated glomerular filtration rate in hospitalised older patients (over 65) with COVID-19: a multicentre, European, observational cohort study},
author = {Carter, B. and Ramsay, E. and Short, R. and Goodison, S. and Lumsden, J. and Khan, A. and Braude, P. and Vilches-Moraga, A. and Quinn, T. and McCarthy, K. and Hewitt, J. and Myint, P. and Bruce, E. and Einarsson, A. and McCrorie, K. and Aggrey, K. and Bilan, J. and Hartrop, K. and Murphy, C. and McGovern, A. and Clini, E. and Guaraldi, G. and Verduri, A. and Bisset, C. and Alexander, R. and Kelly, J. and Murphy, C. and Mutasem, T. and Singh, S. and Paxton, D. and Harris, W. and Moug, S. and Galbraith, N. and Bhatti, E. and Edwards, J. and Duffy, S. and Espinoza, M. and Kneen, T. and Dafnis, A. and Allafi, H. and Vidal, M. and Price, A. and Pearce, L. and Lee, T. and Sangani, S. and Garcia, M. and Davey, C. and Jones, S. and Lunstone, K. and Cavenagh, A. and Silver, C. and Telford, T. and Simmons, R.},
month = {feb},
year = {2022},
abstract = {Background: The reduced renal function has prognostic significance in COVID-19 and it has been linked to mortality in the general population. Reduced renal function is prevalent in older age and thus we set out to better understand its effect on mortality. Methods: Patient clinical and demographic data was taken from the COVID-19 in Older People (COPE) study during two periods (February–June 2020 and October 2020–March 2021, respectively). Kidney function on admission was measured using estimated glomerular filtration rate (eGFR). The primary outcomes were time to mortality and 28-day mortality. Secondary outcome was length of hospital stay. Data were analysed with multilevel Cox proportional hazards regression, and multilevel logistic regression and adjusted for individual patient clinical and demographic characteristics. Results: One thousand eight hundred two patients (55.0% male; median [IQR] 80 [73–86] years) were included in the study. 28-day mortality was 42.3% (n = 742). 48% (n = 801) had evidence of renal impairment on admission. Using a time-to-event analysis, reduced renal function was associated with increased in-hospital mortality (compared to eGFR ≥ 60 [Stage 1&amp;2]): eGFR 45–59 [Stage 3a] aHR = 1.26 (95%CI 1.02–1.55); eGFR 30–44 [Stage 3b] aHR = 1.41 (95%CI 1.14–1.73); eGFR 1–29 [Stage 4&amp;5] aHR = 1.42 (95%CI 1.13–1.80). In the co-primary outcome of 28-day mortality, mortality was associated with: Stage 3a adjusted odds ratio (aOR) = 1.18 (95%CI 0.88–1.58), Stage 3b aOR = 1.40 (95%CI 1.03–1.89); and Stage 4&amp;5 aOR = 1.65 (95%CI 1.16–2.35). Conclusion: eGFR on admission is a good independent predictor of mortality in hospitalised older patients with COVID-19 population. We found evidence of a dose-response between reduced renal function and increased mortality.},
volume = {22},
issue = {1},
journal = {BMC Geriatrics},
publisher = {Springer Nature},
url = {http://dx.doi.org/10.1186/s12877-022-02782-5},
}
