tetano
Editor, Senior Moderator
Clin Exp Nephrol
. 2023 Nov 14.
doi: 10.1007/s10157-023-02428-9. Online ahead of print. The relation between proteinuria and the severity of COVID-19
Akira Fukui[SUP] 1 [/SUP], Kohei Takeshita[SUP] 2 [/SUP], Akio Nakashima[SUP] 3 [/SUP], Yukio Maruyama[SUP] 3 [/SUP], Nobuo Tsuboi[SUP] 3 [/SUP], Tokio Hoshina[SUP] 4 [/SUP], Takashi Yokoo[SUP] 3 [/SUP]
Affiliations
Background: The association between proteinuria, which is also an indicator of chronic kidney disease (CKD), and coronavirus disease 2019 (COVID-19) severity is unclear.
Methods: We selected 342 hospitalized patients with COVID-19 diagnosed via polymerase chain reaction testing between February 2020 and October 2022 and who had at least one urinalysis 14-365 days before admission.
Results: Proteinuria before admission was associated neither with oxygen administration nor developing pneumonia in multivariate analysis (odds ratio [OR] 1.03; 95% confidence interval (CI) 0.44-2.40, p = 0.95 and OR 1.01; 95% CI 0.47-2.17, p = 0.98, respectively). Proteinuria on admission was associated both with oxygen administration and developing pneumonia in multivariate analysis (OR 3.29; 95% CI 1.37-7.88, p < 0.01 and OR 3.81; 95% CI 1.68-8.62, p < 0.01, respectively). The percentage of patients with proteinuria on admission was significantly higher than those before admission (37.4% vs. 17.8%; p < 0.01). In the subgroup analysis, proteinuria on admission among patients with eGFR ≥ 60 mL/min/1.73 m[SUP]2[/SUP] was associated with both oxygen administration and developing pneumonia (OR 4.86; 95% CI 1.22-19.38, p = 0.03, OR 3.65; 95% CI 1.06-12.58, p = 0.04, respectively). In contrast, proteinuria on admission among patients with eGFR < 60 mL/min/1.73 m[SUP]2[/SUP] was associated with developing pneumonia (OR 6.45; 95%CI 1.78-23.35, p = 0.01), not with oxygen administration (OR 3.28; 95% CI 0.92-11.72, p = 0.07).
Conclusions: Although underlying proteinuria before admission was not associated with COVID-19 severity, proteinuria on admission was associated with oxygen demand and developing pneumonia.
Keywords: COVID-19 severity; Chronic kidney disease (CKD); Estimated glomerular filtration rate (eGFR); Proteinuria; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
. 2023 Nov 14.
doi: 10.1007/s10157-023-02428-9. Online ahead of print. The relation between proteinuria and the severity of COVID-19
Akira Fukui[SUP] 1 [/SUP], Kohei Takeshita[SUP] 2 [/SUP], Akio Nakashima[SUP] 3 [/SUP], Yukio Maruyama[SUP] 3 [/SUP], Nobuo Tsuboi[SUP] 3 [/SUP], Tokio Hoshina[SUP] 4 [/SUP], Takashi Yokoo[SUP] 3 [/SUP]
Affiliations
- PMID: 37962747
- DOI: 10.1007/s10157-023-02428-9
Background: The association between proteinuria, which is also an indicator of chronic kidney disease (CKD), and coronavirus disease 2019 (COVID-19) severity is unclear.
Methods: We selected 342 hospitalized patients with COVID-19 diagnosed via polymerase chain reaction testing between February 2020 and October 2022 and who had at least one urinalysis 14-365 days before admission.
Results: Proteinuria before admission was associated neither with oxygen administration nor developing pneumonia in multivariate analysis (odds ratio [OR] 1.03; 95% confidence interval (CI) 0.44-2.40, p = 0.95 and OR 1.01; 95% CI 0.47-2.17, p = 0.98, respectively). Proteinuria on admission was associated both with oxygen administration and developing pneumonia in multivariate analysis (OR 3.29; 95% CI 1.37-7.88, p < 0.01 and OR 3.81; 95% CI 1.68-8.62, p < 0.01, respectively). The percentage of patients with proteinuria on admission was significantly higher than those before admission (37.4% vs. 17.8%; p < 0.01). In the subgroup analysis, proteinuria on admission among patients with eGFR ≥ 60 mL/min/1.73 m[SUP]2[/SUP] was associated with both oxygen administration and developing pneumonia (OR 4.86; 95% CI 1.22-19.38, p = 0.03, OR 3.65; 95% CI 1.06-12.58, p = 0.04, respectively). In contrast, proteinuria on admission among patients with eGFR < 60 mL/min/1.73 m[SUP]2[/SUP] was associated with developing pneumonia (OR 6.45; 95%CI 1.78-23.35, p = 0.01), not with oxygen administration (OR 3.28; 95% CI 0.92-11.72, p = 0.07).
Conclusions: Although underlying proteinuria before admission was not associated with COVID-19 severity, proteinuria on admission was associated with oxygen demand and developing pneumonia.
Keywords: COVID-19 severity; Chronic kidney disease (CKD); Estimated glomerular filtration rate (eGFR); Proteinuria; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).