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2021년 제72차 대한내과학회 추계학술대회
￭S-618 ￭ Clinical courses and outcomes in Coronavirus disease 2019 patients
with chronic kidney disease
부산대학교병원 내과1, 부산대학교병원 감염내과2, 부산대학교병원 호흡기알레르기내과3
김가기
1, 이정은
2, 이순옥
2, 김계형
2, 이선희
2, 이광하
3, 이신원
2Background/Aims: Coronavirus disease 2019 (COVID-19) progresses to severe disease and worse outcomes in patients with chronic diseases. Chronic kidney disease (CKD) is one of the most important chronic diseases that can affect the clinical courses of infections.
Therefore, this study aimed to investigate the clinical characteristics and outcomes of COVID-19 in patients with CKD.
Methods: We performed a retrospective cohort study of COVID-19 patients at Pusan national university hospital in Busan, Korea.
Patients admitted to the hospital between February 2020 and May 2021 with COVID-19 were included. The presence of CKD was defined as estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73㎡ within the 6 months before COVID-19 hospitalization.
We assigned the patients to the CKD group and non-CKD group based on the presence of CKD and compared clinical courses and outcomes between both groups.
Results: A total of 567 COVID-19 patients were included in this study, the mean age of the patients was 63.2 ± 22.2 years, and 272 (48%) were male. Among the included patients, 86 (15.2%) had CKD, and 14 (2.5%) received dialysis. CKD patients contracted by COVID-19 were more likely to have comorbidities such as hypertension, diabetes, coronary artery diseases, chronic pulmonary diseases, and malignancy. Significantly higher proportions of the CKD patients exhibited dyspnea, febrile sensation, and myalgia. Proportions of pneumonia cases were higher in CKD patients than in non-CKD patients. Oxygen supplements were required in 60.5% (52/86) of CKD patients while in 31.8% (153/481) of non-CKD patients (p<0.001). Among 86 CKD patients, 47.7%, 4.7%, and 8.1% received low flow oxygen, high flow oxygen, and mechanical ventilation, respectively. Intensive care unit (ICU) care was required in 12.8%
of CKD patients while in 6.4% of non-CKD patients (p=0.045). There was no significant difference in mortality between both groups (CKD, 8.1% [7/86] vs. non-CKD, 5.0% [24/481], p=0.298).
Conclusions: When CKD patients contract COVID-19, oxygen supplements or ICU care is more often required, although we found no significant differences in mortality. We need to be more cautious in the treatment of COVID-19 patients with CKD.
