# Impact of COVID-19 on chronic kidney disease progression in non-dialysis patients: a retrospective cohort study in Palestine

## TL;DR

This study shows that non-dialysis chronic kidney disease patients who contracted COVID-19 experienced faster kidney function decline and worse health outcomes, including higher mortality and hospitalization rates.

## Contribution

The study provides new evidence on the significant negative impact of COVID-19 on CKD progression in a Palestinian population.

## Key findings

- CKD patients with COVID-19 had a 3.7-fold higher risk of rapid eGFR decline compared to those without.
- Mortality rates were 4.4 times higher in CKD patients who had COVID-19.
- Hospital admissions and dialysis initiation were significantly higher in the infected group.

## Abstract

This study aims to evaluate the impact of COVID-19 on the progression of CKD in non-dialysis patients and its relation to clinical outcomes in Palestine.

We conducted a retrospective cohort study that followed non-dialysis CKD patients receiving treatment at outpatient clinics in governmental hospitals. Out of the 248 CKD patients who met the inclusion criteria, 98 were diagnosed with COVID-19 between March 2020 and March 2022. We collected data at three distinct time intervals, both prior to and after their COVID-19 infection. We examined the decline in eGFR and gathered demographic information, hospitalization, and mortality rates. The drop in eGFR was recorded 15 months from baseline.

The mean age of the patients was 55 years, with 55.6% being male. Patients diagnosed with COVID-19 faced a significantly higher risk of rapid deterioration in eGFR, with a 3.7-fold increase compared to those without COVID-19 (ap-value: <0.001; aOR: 3.7; 95% CI: 2.1–6.3). Additionally, COVID-19 patients had 4.4 times higher mortality rates (ap-value: 0.005; aOR: 4.4; 95% CI: 1.6–12.4), 13.3 times higher rates of dialysis initiation within 15 months post-baseline (ap-value: <0.001; aOR: 13.3; 95% CI: 6.1–28.7), and 3.5 times higher rates of hospital admissions (ap-value: <0.001; aOR: 3.5; 95% CI: 1.8–6.7) compared to the COVID-19 negative group.

CKD patients who contract COVID-19 experience a more rapid decline in kidney function, leading to worse health outcomes, including increased mortality rates, a greater need for dialysis, and higher hospitalization rates.

Patients with CKD who contract COVID-19 experience a rapid decline in kidney function, which increases their need for on dialysis.COVID-19-infected individuals with CKD exhibit an elevated likelihood of being hospitalized, requiring ICU admission, respiratory support, and a heightened mortality rate.

Patients with CKD who contract COVID-19 experience a rapid decline in kidney function, which increases their need for on dialysis.

COVID-19-infected individuals with CKD exhibit an elevated likelihood of being hospitalized, requiring ICU admission, respiratory support, and a heightened mortality rate.