Kidney Impairment in Patients With SARS-CoV-2 Infection

At the 59th ERA Congress, Maria-Daniela Tanasescu and colleagues presented results of a study designed to compared renal impairment between patients with SARS-CoV-2 infection in two different time periods with dominant beta and delta SARS-CoV-2 variants, with or without prior chronic kidney disease (CKD). The results were reported in a presentation titled SARS-CoV-2 Infection and Kidney Impairment.

The study cohort included 80 patients from the Bucharest Emergency University Hospital nephrology ward. Of the 80 patients, 40 were diagnosed with SARS-CoV-2 beta variant dominant and 40 were diagnosed with SARS-CoV-2 delta variant dominant. Positive PCR tests confirmed SARS-CoV-2 infections in all of the 80 patients. The values of urea, creatinine, sodium, potassium, calcium, phosphorous, and hemoglobin were observed for all patients during hospitalization.

In the group with the beta variant, only four of the 40 patients had documented preexisting CKD. The average length-of-stay was 14 days; advancement of acute respiratory failure in three patients required transfer to the intensive care unit (ICU). In the delta variant group, three of the 40 patients were diagnosed with acute kidney injury (AKI). Average length-of-stay was 14 days; advancement of acute respiratory failure in three patients required transfer to the ICU.

In the beta variant dominant group, 90% of patients (36/40), analysis of biologic parameters showed minimal change in values during hospitalization with normal maintenance of renal function. In two patients diagnosed with CKD, renal function improved with an average of three to four hemodialysis sessions, while maintaining a minimum nitrogen level. Two patients with CKD experienced a decline in renal function, leading to initiation of hemodialysis.

In the delta variant dominant group, 82.5% of patients (33/40) showed minimal change in the examined parameters during hospitalization with normal maintenance of renal function. In 10% of the cohort (4/40), renal function declined in the context of multiple system organ failure, followed by death. Three patients who were admitted with AKI had renal dysfunction resolved by the time of hospital discharge.

There were no statistically significant differences in measured parameters between the two time periods with the different SARS-CoV-2 strings.

In summary, the authors said, “According to this statistical analysis, the delta variant does not cause more kidney damage than the beta variant of SARS-CoV-2. For the six patients (7.5%) with renal impairment, two from the beta batch (2.5%) and four from the delta batch (5%), the suspicion of renal damage in SARS-CoV-2 infection may be raised, but excluding other causes of renal damage is necessary. For the three patients (7.5%) with AKI from the delta batch, the suspicion of renal damage caused by COVID-19 may be raised because there were no other causes for renal impairment.”

Source: Tanasescu M-D, Botocan A, Tanase EGB, et al. SARS-CoV-2 Infection and Kidney Impairment. Abstract of a presentation at the 59th European Renal Association Congress, Paris, France, May 19-22, 2022.