Prognostic value of estimated glomerular filtration rate in hospitalised older patients (over 65) with COVID-19: a multicentre, European, observational cohort study - Repository

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: http://dx.doi.org/10.1186/s12877-022-02782-5

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&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&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&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.

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© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Cite as

Carter, B., Ramsay, E., Short, R., Goodison, S., Lumsden, J., Khan, A., Braude, P., Vilches-Moraga, A., Quinn, T., McCarthy, K., Hewitt, J., Myint, P., Bruce, E., Einarsson, A., McCrorie, K., Aggrey, K., Bilan, J., Hartrop, K., Murphy, C., McGovern, A., Clini, E., Guaraldi, G., Verduri, A., Bisset, C., Alexander, R., Kelly, J., Murphy, C., Mutasem, T., Singh, S., Paxton, D., Harris, W., Moug, S., Galbraith, N., Bhatti, E., Edwards, J., Duffy, S., Espinoza, M., Kneen, T., Dafnis, A., Allafi, H., Vidal, M., Price, A., Pearce, L., Lee, T., Sangani, S., Garcia, M., Davey, C., Jones, S., Lunstone, K., Cavenagh, A., Silver, C., Telford, T. & Simmons, R. 2022, 'Prognostic value of estimated glomerular filtration rate in hospitalised older patients (over 65) with COVID-19: a multicentre, European, observational cohort study', BMC Geriatrics, 22(1), article no: 119. http://dx.doi.org/10.1186/s12877-022-02782-5

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DOI: http://dx.doi.org/10.1186/s12877-022-02782-5

Repository URI: http://eprints.gla.ac.uk/265263/