Kidney Week

Abstract: PUB009

Effect of CKD on the Severity of COVID-19 in Hypertensive Subjects

Session Information

• Publication Only

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Nieto, Javier, Hospital General Universitario de Ciudad Real, Ciudad Real, Castilla-La Mancha, Spain

Javier Nieto,

• Sánchez Macarro, Maravillas, Universidad Catolica San Antonio de Murcia, Murcia, Murcia, Spain

Maravillas Sánchez Macarro,

• Sobrino, Javier, Fundacio Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Catalunya, Spain

Javier Sobrino,

• Valls-Roca, Francisco, Sociedad Valenciana de HTA y RV, Valencia, Valencia, Spain

Francisco Valls-Roca,

• Iturralde-Iriso, Jesus, Unidad de Atención Primaria La Habana-Cuba., Vitoria, Spain

Jesus Iturralde-Iriso,

• Crespo Sabarís, Rafael, Dirección Médica de Atención Primaria, Logroño, La Rioja, Spain

Rafael Crespo Sabarís,

• García Romanos, Fernando, Centro de Salud Santa Catalina, Palma, Iles Balears, Spain

Fernando García Romanos,

• Fuentes-Jimenez, Francisco, Hospital Universitario Reina Sofia, Cordoba, Andalucía, Spain

Francisco Fuentes-Jimenez,

• Diaz Vera, Alcibiades Segundo, Centro de Salud Elizondo, Pamplona, Navarra, Spain

Alcibiades Segundo Diaz Vera,

• Velasco Soria, Angeles, Centro de Salud San Andrés, Murcia, Spain

Angeles Velasco Soria,

• Gómez Marcos, Manuel Angel, Universidad de Salamanca, Salamanca, Castilla y León, Spain

Manuel Angel Gómez Marcos,

• Abellán Alemán, José, Universidad Catolica San Antonio de Murcia, Murcia, Murcia, Spain

José Abellán Alemán,

Group or Team Name

• HTA-COVID-19 Study Group.

Background

Comorbidities such as hypertension (HTN) or chronic kidney disease (CKD) may worsen the prognosis of subjects infected by SARS-Cov-2 and hypertensives are at greater risk of suffering renal dysfunction.The purpose of this study is to assess the effect of CKD on the progression of COVID-19 in hypertensive patients.

Methods

Multicenter, observational, cross-sectional, retrospective and analytical study. Patients, over 18y, were selected by random sampling in 10 autonomous regions of Spain, among subjects with treated HTN, infected by SARS-Cov-2 under Primary Care Health. CKD was defined as GFR<60 mL/min/1.73m² and/or UACR>30 mg/g creatinine. The Pearsons test and multivariate logistic regression analysis adjusted for age, sex, smoking, and obesity were used to assess the association between the severity of COVID-19 and the presence of CKD in our hypertensive population.

Results

1372 patients were recruited, mean age 67y, women 51%, smoking 13%, obesity 44%, diabetes 28%, controlled HTN 56% (BP<140/ 90mmHg). The severity of the progression of COVID-19 was defined as mild-asymptomatic 971 (71%), hospital admission 401 (29%), ICU admission 74 (5.4%), death 48 (rate of lethality 4%). 63% had CKD with a worse prognosis, since of total hospitalizations we found 69% with CKD vs 31% without it (p=0.0064). 18% of patients with GFR<60 (77y, 54% women) also progressed worse, with 44% hospitalizations, 8% in the ICU, and mortality11%. Comparing mild-asymptomatic subjects with hospitalizated patients, those with reduced GFR had an unfavorable course (OR=2.4; 95%CI:1.6-3.7; p<0.001), without significant differences in BP. There was also greater severity of COVID-19 in smoking patients with CKD (OR=6.8; 95%CI:2.4-19.5; p<0.001) for hospitalization and (OR=6.0; 95%CI:1.7- 21.6; p<0.05) for ICU admission. We did not found any effect of RAS inhibitors, statins or antidiabetic drugs.

Conclusion

The prevalence of CKD among hipertensive subjects infected by SARS-Cov-2, in our Primare Care environment is very high. CKD, even without a reduced GFR, is related to a greater severity in the progression of COVID-19. Smoking seems to exert a deleterious modulatory effect associated to CKD for the disease outcomes.