Estimated glomerular filtration rate in identifying illness severity in newly admitted patients with COVID-19: A single-center study

Abstract

[LANGUAGE= "English"] INTRODUCTION: Early prediction of risk factors for serious illness and death in patients with coronavirus disease 2019 (COVID-19) appears to be a priority. This study aimed to examine whether a single estimated glomerular filtration rate (eGFR) at triage predicts the need for intensive care unit (ICU) admission of patients with COVID-19.

METHODS: This retrospective study included data from patients with COVID-19 at the Bursa Yuksek Ihtisas Training and Research Hospital until October 2020. Patients were assigned to two groups according to their eGFR level at admission: group 1 (eGFR >60 mL/min/1.73 m2) and group 2 (eGFR=30-60 mL/min/1.73 m2).

RESULTS: The results of 1447 consecutive patients diagnosed with COVID-19 were analyzed at hospital admissions. Of these, 1001 patients who met the study criteria were included in the study. The median age of group 2 was higher than group 1: 69 interquartile range (IQR 23) years versus 39 (IQR 23) years (p<0.01). Patients with an eGFR <60 mL/min/1.73 m2 had lower lymphocyte counts while having higher C-reactive protein, d-dimer, lactate dehydrogenase, and fibrinogen levels. The ICU admissions were significantly higher in patients with a baseline eGFR <60 mL/min/1.73 m2 (42.85%) compared with an eGFR >60 mL/min/1.73 m2 (6.42%, p<0.001). There was a weak negative correlation between eGFR and ICU admission (rho=-0.291, p<0.001).

DISCUSSION AND CONCLUSION: The eGFR at admission was strongly correlated with the severity of the disease. Therefore, measuring eGFR in all patients at admission may warrant appropriate triage.

Alternate abstract:

INTRODUCTION: Early prediction of risk factors for serious illness and death in patients with coronavirus disease 2019 (COVID-19) appears to be a priority. This study aimed to examine whether a single estimated glomerular filtration rate (eGFR) at triage predicts the need for intensive care unit (ICU) admission of patients with COVID-19.

METHODS: This retrospective study included data from patients with COVID-19 at the Bursa Yuksek Ihtisas Training and Research Hospital until October 2020. Patients were assigned to two groups according to their eGFR level at admission: group 1 (eGFR >60 mL/min/1.73 m2) and group 2 (eGFR=30-60 mL/min/1.73 m2).

RESULTS: The results of 1447 consecutive patients diagnosed with COVID-19 were analyzed at hospital admissions. Of these, 1001 patients who met the study criteria were included in the study. The median age of group 2 was higher than group 1: 69 interquartile range (IQR 23) years versus 39 (IQR 23) years (p<0.01). Patients with an eGFR <60 mL/min/1.73 m2 had lower lymphocyte counts while having higher C-reactive protein, d-dimer, lactate dehydrogenase, and fibrinogen levels. The ICU admissions were significantly higher in patients with a baseline eGFR <60 mL/min/1.73 m2 (42.85%) compared with an eGFR >60 mL/min/1.73 m2 (6.42%, p<0.001). There was a weak negative correlation between eGFR and ICU admission (rho=-0.291, p<0.001).

DISCUSSION AND CONCLUSION: The eGFR at admission was strongly correlated with the severity of the disease. Therefore, measuring eGFR in all patients at admission may warrant appropriate triage.