An analysis of Geisinger’s electronic health records has revealed chronic kidney disease to be the leading risk factor for hospitalization from COVID-19.
A team of Geisinger researchers studied the health records of 12,971 individuals who were tested for COVID-19 within the Geisinger system between March 7 and May 19. Of this group, 1,604 were COVID-positive and 354 required hospitalization. The team analyzed the records for association between specific clinical conditions, including kidney, cardiovascular, respiratory and metabolic conditions, and COVID-19 hospitalization.
Overall, chronic kidney disease was most strongly associated with hospitalization, and COVID-19 patients with end-stage renal disease were 11 times more likely to be admitted to the hospital than patients without kidney disease.
The results were published in PLOS ONE.
“Previous studies have identified a variety of health conditions associated with an increased risk of COVID-related hospitalization, including diabetes, heart failure, hypertension, and chronic kidney disease. What is significant here is the magnitude of the kidney disease-related risk,” said Alex Chang, M.D., Geisinger nephrologist and co-director of Geisinger’s Kidney Health Research Institute. “These findings highlight the need to prevent COVID-19-related illness in patients with kidney disease and other high-risk conditions.”
How underlying medical conditions increase the risk of COVID-19-related complications is not yet fully clear; however, the study suggests that the physiological stress caused by an excessive inflammatory response to COVID-19 infection could destabilize organs already weakened by chronic disease, or that organ injury from the virus could act as a ‘second-hit’ to these organs.
“Consistent with this hypothesis, kidney and heart are among the tissues with the highest expression of ACE2, a SARS-CoV-2 receptor,” the team wrote.
While the sample size studied was relatively small, Geisinger’s resources as an integrated health system allowed for a fairly comprehensive analysis of available data.
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