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. 2020 May 9;13(3):340-346.
doi: 10.1093/ckj/sfaa083. eCollection 2020 Jun.

Kidney manifestations of mild, moderate and severe coronavirus disease 2019: a retrospective cohort study

Daqing Hong  1 , Lin Long  2 , Amanda Y Wang  3   4   5 , Yu Lei  6 , Yun Tang  1 , Jia Wei Zhao  7 , Xiaofei Song  3   4   5 , Yanan He  3   4   5 , Ergang Wen  1 , Ling Zheng  1 , Guisen Li  1 , Li Wang  1
Affiliations

Kidney manifestations of mild, moderate and severe coronavirus disease 2019: a retrospective cohort study

Daqing Hong et al. Clin Kidney J. .

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a pandemic that has affected more than 3 million patients globally. Previous data from Wuhan city showed that acute kidney injury (AKI), proteinuria and hematuria occurred frequently in patients with severe COVID-19. However, the prevalence of kidney injury in milder cases remains unclear.

Methods: This retrospective study included two major consecutive cohorts of COVID-19 patients in Sichuan Province. Baseline characteristics, laboratory data including renal function, proteinuria and dipstick hematuria, and other laboratory parameters were collected. A subgroup of patients was followed up for 2-4 weeks to evaluate the short-term outcome of renal impairment.

Results: Overall, 168 COVID-19-positive patients were included in the study. The majority of patients (79.7%) were diagnosed with mild or moderate disease. Half of patients presented with fever; however, in The Tibetan cohort, fever only occurred in 13.4% of patients. On hospital admission, proteinuria and dipstick hematuria were noted in 18.4% and 17.4% of patients, respectively, while AKI only occurred in one patient. Further analysis showed that severe or critical COVID-19 was associated with higher risk of proteinuria [relative risk (RR) 7.37, 95% confidence interval (CI) 2.45-22.18, P = 3.8 × 10-4] and dipstick hematuria (RR 8.30, 95% CI 2.69-25.56, P = 2.3 × 10-4). Proteinuria, dipstick hematuria, or the combination of proteinuria and hematuria could significantly predict severe or critical severe COVID-19.

Conclusions: Proteinuria and dipstick hematuria are not uncommon in patients with COVID-19 infection, especially in severe or critical cases.

Keywords: COVID-19; acute kidney injury.

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Figures

FIGURE 1
FIGURE 1
Distribution of urine protein and dipstick hematuria in patients according to the severity of COVID-19. (a) Proteinuria; (b) dipstick hematuria.
FIGURE 2
FIGURE 2
The severity category of COVID-19 according to the urinalysis. (a) Proteinuria; (b) dipstick hematuria.
See this image and copyright information in PMC

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References

    1. Zhu N, Zhang D, Wang W. et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382: 727–733 - PMC - PubMed
    1. Lu R, Zhao X, Li J. et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395: 565–574 - PMC - PubMed
    1. WHO. Coronavirus Disease (COVID-2019) Situation Reports Situation Report—81, 10 April 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/2... (11 April 2020, date last accessed)
    1. Guan W, Ni Z, Hu Y. et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; doi:10.1056/NEJMoa2002032 - PMC - PubMed
    1. Pung R, Chiew CJ, Young BE. et al. Investigation of three clusters of COVID-19 in Singapore: implications for surveillance and response measures. Lancet 2020; doi:10.1016/S0140-6736(20)30528-6 - PMC - PubMed