COVID-19 infection and kidney disease (KD) pose a significant risk of death. Therefore, understanding the determinants of mortality and KD may aid patient care and outcome. From January to June 2020, prospective multicenter observational research will be undertaken in a multiracial Asian nation to investigate predictors of mortality and acute kidney damage (AKI) in hospitalized COVID-19 patients.

The research had 6,078 participants in total. The average age was 37.3 (16.8) years, with 71% of the population male, 59.4% Malay, 6.7% Chinese, 2.3% Indian, and 31.7% of other races. AKI was observed in 3.5% of patients, with 1.6% having the pre-existing chronic renal disease (CKD). The overall case fatality rate (CFR) was 1.3%. Patients with KD (AKI and CKD) had a CFR of 20%. Many variables have been linked to an increased risk of mortality and AKI. However, after controlling for confounders, age (>70 years), Chinese ethnicity, diabetes mellitus (DM), and KD were significant predictors of mortality. At presentation, AKI was predicted by age (>51 years), diabetes, and severity. When compared to Malay, Chinese were 2.58 times more likely to die (P =.036). The ability of the center to treat, ventilate, and dialyze patients had a substantial impact on mortality. The most prevalent symptoms of AKI were fever, cough, and dyspnea. They had a lower absolute lymphocyte count, were more likely to be admitted to ICU, required more ventilation, and were hospitalized for longer. Death and AKI in COVID-19 patients are influenced by patient and center characteristics. The study also indicated racial discrepancies in mortality and center capacity in this mixed Asian country.

Reference:onlinelibrary.wiley.com/doi/10.1111/nep.14045