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Increased vulnerability to Covid-19 in chronic kidney disease

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@article{73d5ee861a9e4299b447a172b7ad034a,
title = "Increased vulnerability to Covid-19 in chronic kidney disease",
abstract = "BACKGROUND: The significance of chronic kidney disease on susceptibility to COVID-19 and subsequent outcomes remains unaddressed.OBJECTIVE: To investigate the association of estimated glomerular filtration rate (eGFR) on risk of contracting COVID-19 and subsequent adverse outcomes.METHODS: Rates of hospital-diagnosed COVID-19 were compared across strata of eGFR based on conditional logistic regression using a nested case-control framework with 1:4 matching of patients diagnosed with COVID-19 with controls from the Danish general population on age, gender, diabetes and hypertension. Risk of subsequent severe COVID-19 or death was assessed in a cohort study with comparisons across strata of eGFR based on adjusted Cox regression models with G-computation of results to determine 60-day risk standardized to the distribution of risk factors in the sample.RESULTS: Estimated glomerular filtration rate was inversely associated with rate of hospital-diagnosed COVID-19: eGFR 61-90 mL/min/1.73m 2 HR 1.13 (95% CI 1.03-1.25), P = 0.011; eGFR 46-60 mL/min/1.73m 2 HR 1.26 (95% CI 1.06-1.50), P = 0.008; eGFR 31-45 mL/min/1.73m 2 HR 1.68 (95% CI 1.34-2.11), P < 0.001; and eGFR ≤ 30 mL/min/1.73m 2 3.33 (95% CI 2.50-4.42), P < 0.001 (eGFR > 90 mL/min/1.73m 2 as reference), and renal impairment was associated with progressive increase in standardized 60-day risk of death or severe COVID-19; eGFR > 90 mL/min/1.73m 2 13.9% (95% CI 9.7-15.0); eGFR 90-61 mL/min/1.73m 2 16.1% (95% CI 14.5-17.7); eGFR 46-60 mL/min/1.73m 2 17.8% (95% CI 14.7-21.2); eGFR 31-45 mL/min/1.73m 2 22.6% (95% CI 18.2-26.2); and eGFR ≤ 30 mL/min/1.73m 2 23.6% (95% CI 18.1-29.1). CONCLUSIONS: Renal insufficiency was associated with progressive increase in both rate of hospital-diagnosed COVID-19 and subsequent risk of adverse outcomes. Results underscore a possible vulnerability associated with impaired renal function in relation to COVID-19.",
keywords = "Adult, Aged, COVID-19/epidemiology, Case-Control Studies, Denmark/epidemiology, Disease Susceptibility, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Pandemics, Pneumonia, Viral/epidemiology, Renal Insufficiency, Chronic/complications, Retrospective Studies, Risk Factors, SARS-CoV-2, estimated glomerular filtration rate, renal insufficiency, COVID-19",
author = "Nicholas Carlson and Karl-Emil Nelveg-Kristensen and {Freese Ballegaard}, Ellen and Bo Feldt-Rasmussen and Mads Hornum and Anne-Lise Kamper and Gunnar Gislason and Christian Torp-Pedersen",
note = "{\textcopyright} 2021 Association for Publication of The Journal of Internal Medicine.",
year = "2021",
month = jul,
doi = "10.1111/joim.13239",
language = "English",
volume = "290",
pages = "166--178",
journal = "Journal of Internal Medicine",
issn = "0954-6820",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - Increased vulnerability to Covid-19 in chronic kidney disease

AU - Carlson, Nicholas

AU - Nelveg-Kristensen, Karl-Emil

AU - Freese Ballegaard, Ellen

AU - Feldt-Rasmussen, Bo

AU - Hornum, Mads

AU - Kamper, Anne-Lise

AU - Gislason, Gunnar

AU - Torp-Pedersen, Christian

N1 - © 2021 Association for Publication of The Journal of Internal Medicine.

PY - 2021/7

Y1 - 2021/7

N2 - BACKGROUND: The significance of chronic kidney disease on susceptibility to COVID-19 and subsequent outcomes remains unaddressed.OBJECTIVE: To investigate the association of estimated glomerular filtration rate (eGFR) on risk of contracting COVID-19 and subsequent adverse outcomes.METHODS: Rates of hospital-diagnosed COVID-19 were compared across strata of eGFR based on conditional logistic regression using a nested case-control framework with 1:4 matching of patients diagnosed with COVID-19 with controls from the Danish general population on age, gender, diabetes and hypertension. Risk of subsequent severe COVID-19 or death was assessed in a cohort study with comparisons across strata of eGFR based on adjusted Cox regression models with G-computation of results to determine 60-day risk standardized to the distribution of risk factors in the sample.RESULTS: Estimated glomerular filtration rate was inversely associated with rate of hospital-diagnosed COVID-19: eGFR 61-90 mL/min/1.73m 2 HR 1.13 (95% CI 1.03-1.25), P = 0.011; eGFR 46-60 mL/min/1.73m 2 HR 1.26 (95% CI 1.06-1.50), P = 0.008; eGFR 31-45 mL/min/1.73m 2 HR 1.68 (95% CI 1.34-2.11), P < 0.001; and eGFR ≤ 30 mL/min/1.73m 2 3.33 (95% CI 2.50-4.42), P < 0.001 (eGFR > 90 mL/min/1.73m 2 as reference), and renal impairment was associated with progressive increase in standardized 60-day risk of death or severe COVID-19; eGFR > 90 mL/min/1.73m 2 13.9% (95% CI 9.7-15.0); eGFR 90-61 mL/min/1.73m 2 16.1% (95% CI 14.5-17.7); eGFR 46-60 mL/min/1.73m 2 17.8% (95% CI 14.7-21.2); eGFR 31-45 mL/min/1.73m 2 22.6% (95% CI 18.2-26.2); and eGFR ≤ 30 mL/min/1.73m 2 23.6% (95% CI 18.1-29.1). CONCLUSIONS: Renal insufficiency was associated with progressive increase in both rate of hospital-diagnosed COVID-19 and subsequent risk of adverse outcomes. Results underscore a possible vulnerability associated with impaired renal function in relation to COVID-19.

AB - BACKGROUND: The significance of chronic kidney disease on susceptibility to COVID-19 and subsequent outcomes remains unaddressed.OBJECTIVE: To investigate the association of estimated glomerular filtration rate (eGFR) on risk of contracting COVID-19 and subsequent adverse outcomes.METHODS: Rates of hospital-diagnosed COVID-19 were compared across strata of eGFR based on conditional logistic regression using a nested case-control framework with 1:4 matching of patients diagnosed with COVID-19 with controls from the Danish general population on age, gender, diabetes and hypertension. Risk of subsequent severe COVID-19 or death was assessed in a cohort study with comparisons across strata of eGFR based on adjusted Cox regression models with G-computation of results to determine 60-day risk standardized to the distribution of risk factors in the sample.RESULTS: Estimated glomerular filtration rate was inversely associated with rate of hospital-diagnosed COVID-19: eGFR 61-90 mL/min/1.73m 2 HR 1.13 (95% CI 1.03-1.25), P = 0.011; eGFR 46-60 mL/min/1.73m 2 HR 1.26 (95% CI 1.06-1.50), P = 0.008; eGFR 31-45 mL/min/1.73m 2 HR 1.68 (95% CI 1.34-2.11), P < 0.001; and eGFR ≤ 30 mL/min/1.73m 2 3.33 (95% CI 2.50-4.42), P < 0.001 (eGFR > 90 mL/min/1.73m 2 as reference), and renal impairment was associated with progressive increase in standardized 60-day risk of death or severe COVID-19; eGFR > 90 mL/min/1.73m 2 13.9% (95% CI 9.7-15.0); eGFR 90-61 mL/min/1.73m 2 16.1% (95% CI 14.5-17.7); eGFR 46-60 mL/min/1.73m 2 17.8% (95% CI 14.7-21.2); eGFR 31-45 mL/min/1.73m 2 22.6% (95% CI 18.2-26.2); and eGFR ≤ 30 mL/min/1.73m 2 23.6% (95% CI 18.1-29.1). CONCLUSIONS: Renal insufficiency was associated with progressive increase in both rate of hospital-diagnosed COVID-19 and subsequent risk of adverse outcomes. Results underscore a possible vulnerability associated with impaired renal function in relation to COVID-19.

KW - Adult

KW - Aged

KW - COVID-19/epidemiology

KW - Case-Control Studies

KW - Denmark/epidemiology

KW - Disease Susceptibility

KW - Female

KW - Glomerular Filtration Rate

KW - Humans

KW - Male

KW - Middle Aged

KW - Pandemics

KW - Pneumonia, Viral/epidemiology

KW - Renal Insufficiency, Chronic/complications

KW - Retrospective Studies

KW - Risk Factors

KW - SARS-CoV-2

KW - estimated glomerular filtration rate

KW - renal insufficiency

KW - COVID-19

UR - http://www.scopus.com/inward/record.url?scp=85101042538&partnerID=8YFLogxK

U2 - 10.1111/joim.13239

DO - 10.1111/joim.13239

M3 - Journal article

C2 - 33452733

VL - 290

SP - 166

EP - 178

JO - Journal of Internal Medicine

JF - Journal of Internal Medicine

SN - 0954-6820

IS - 1

ER -

ID: 61786873