Journal of Clinical Medicine (Oct 2022)
Association between Renal Function at Admission and COVID-19 in-Hospital Mortality in Southern Italy: Findings from the Prospective Multicenter Italian COVOCA Study
- Raffaele Galiero,
- Vittorio Simeon,
- Giuseppe Loffredo,
- Alfredo Caturano,
- Luca Rinaldi,
- Erica Vetrano,
- Giulia Medicamento,
- Maria Alfano,
- Domenico Beccia,
- Chiara Brin,
- Sara Colantuoni,
- Jessica Di Salvo,
- Raffaella Epifani,
- Riccardo Nevola,
- Raffaele Marfella,
- Celestino Sardu,
- Carmine Coppola,
- Ferdinando Scarano,
- Paolo Maggi,
- Cecilia Calabrese,
- Pellegrino De Lucia Sposito,
- Carolina Rescigno,
- Costanza Sbreglia,
- Fiorentino Fraganza,
- Roberto Parrella,
- Annamaria Romano,
- Giosuele Calabria,
- Benedetto Polverino,
- Antonio Pagano,
- Fabio Giuliano Numis,
- Carolina Bologna,
- Mariagrazia Nunziata,
- Vincenzo Esposito,
- Nicola Coppola,
- Nicola Maturo,
- Rodolfo Nasti,
- Pierpaolo Di Micco,
- Alessandro Perrella,
- Miriam Lettieri,
- Luigi Elio Adinolfi,
- Paolo Chiodini,
- Ferdinando Carlo Sasso,
- on behalf of COVOCA Study Group
Affiliations
- Raffaele Galiero
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Vittorio Simeon
- Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, Italy
- Giuseppe Loffredo
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Alfredo Caturano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Erica Vetrano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Giulia Medicamento
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Maria Alfano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Domenico Beccia
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Chiara Brin
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Sara Colantuoni
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Jessica Di Salvo
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Raffaella Epifani
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Riccardo Nevola
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Carmine Coppola
- Hepatology Unit, Internal Medicine, Area Stabiese Hospital, 80053 Naples, Italy
- Ferdinando Scarano
- COVID Center “S. Anna e SS. Madonna della Neve” Hospital, 80042 Boscotrecase, Italy
- Paolo Maggi
- U.O.C. Infectious and Tropical Diseases, S. Anna e S. Sebastiano Hospital, 81100 Caserta, Italy
- Cecilia Calabrese
- Pneumologia Vanvitelli Department of Translational Medical Sciences, University of Campania ‘Luigi Vanvitelli’, AORN Ospedali dei Colli, Via Leonardo Bianchi, 80131 Naples, Italy
- Pellegrino De Lucia Sposito
- Covid Center-Maddaloni Hospital, 80124 Maddaloni, Italy
- Carolina Rescigno
- U.O.C. Infectious Diseases and Neurology, Cotugno Hospital, 80131 Naples, Italy
- Costanza Sbreglia
- U.O.C. Infectious Diseases of the Elderly, Cotugno Hospital, 80131 Naples, Italy
- Fiorentino Fraganza
- U.O.C. Anestesia and Intensive Care Unit, Cotugno Hospital, 80131 Naples, Italy
- Roberto Parrella
- U.O.C. Respiratory Infectious Diseases, Cotugno Hospital, 80131 Naples, Italy
- Annamaria Romano
- U.O.C. Pneumology, Moscati Hospital, 83100 Avellino, Italy
- Giosuele Calabria
- IXth Division of Infectious Diseases and Interventional Ultrasound, Cotugno Hospital, 80131 Naples, Italy
- Benedetto Polverino
- “Giovanni da Procida” Hospital, 84126 Salerno, Italy
- Antonio Pagano
- Emergency and Acceptance Unit, “Santa Maria delle Grazie” Hospital, 80078 Pozzuoli, Italy
- Fabio Giuliano Numis
- Emergency and Acceptance Unit, “Santa Maria delle Grazie” Hospital, 80078 Pozzuoli, Italy
- Carolina Bologna
- Internal Medicine Unit, Ospedale Del Mare, 80147 Naples, Italy
- Mariagrazia Nunziata
- U.O.C. Internal Medicine-Moscati Hospital, 83100 Avellino, Italy
- Vincenzo Esposito
- IVth Division of Immunodeficiency and Gender Infectious Diseases, Cotugno Hospital, 80131 Naples, Italy
- Nicola Coppola
- Department of Mental Health and Public Medicine, Centro COVID A.O.U. Vanvitelli, 80131 Naples, Italy
- Nicola Maturo
- U.O.S.D. Infectious Diseases Emergency and Acceptance, Cotugno Hospital, 80131 Naples, Italy
- Rodolfo Nasti
- Emergency Division, A.O.R.N. “Antonio Cardarelli”, Via Antonio Cardarelli 9, 80131 Naples, Italy
- Pierpaolo Di Micco
- Department of Internal Medicine, Fatebenefratelli Hospital of Naples, 80123 Naples, Italy
- Alessandro Perrella
- Task Force COVID-19 Regione Campania, 80131 Napoli, Italy
- Miriam Lettieri
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, 3.31 Core Technology Facility, 46 Grafton Street, Manchester M13 9NT, UK
- Luigi Elio Adinolfi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- Paolo Chiodini
- Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, Italy
- Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy
- on behalf of COVOCA Study Group
- DOI
- https://doi.org/10.3390/jcm11206121
- Journal volume & issue
-
Vol. 11,
no. 20
p. 6121
Abstract
Background. Evidence has shown a close association between COVID-19 infection and renal complications in both individuals with previously normal renal function and those with chronic kidney disease (CKD). Methods. The aim of this study is to evaluate the in-hospital mortality of SARS-CoV-2 patients according to their clinical history of CKD or estimated glomerular filtration rate (eGFR). This is a prospective multicenter observational cohort study which involved adult patients (≥18 years old) who tested positive with SARS-CoV-2 infection and completed their hospitalization in the period between November 2020 and June 2021. Results. 1246 patients were included in the study, with a mean age of 64 years (SD 14.6) and a median duration of hospitalization of 15 days (IQR 9–22 days). Cox’s multivariable regression model revealed that mortality risk was strongly associated with the stage of renal impairment and the Kaplan–Meier survival analysis showed a progressive and statistically significant difference (p < 0.0001) in mortality according to the stage of CKD. Conclusion. This study further validates the association between CKD stage at admission and mortality in patients hospitalized for COVID-19. The risk stratification based on eGFR allows clinicians to identify the subjects with the highest risk of intra-hospital mortality despite the duration of hospitalization.
Keywords