Kidney Manifestations Of Mild, Moderate And Severe Coronavirus Disease 2019: A Retrospective Cohort Study

Background. Coronavirus disease 2019 (COVID-19) is a pandemic that has affected more than 3 million patients globally. Previous data from Wuhan city showed that acute kidney injury (AKI), proteinuria and hematuria occurred frequently in patients with severe COVID-19. However, the prevalence of kidney injury in milder cases remains unclear.Methods. This retrospective study included twomajor consecutive cohorts of COVID-19 patients in Sichuan Province. Baseline characteristics, laboratory data including renal function, proteinuria and dipstick hematuria, and other laboratory parameters were collected. A subgroup of patients was followed up for 2-4weeks to evaluate the short-termoutcome of renal impairment.Results. Overall, 168 COVID-19-positive patients were included in the study. The majority of patients (79.7%) were diagnosed with mild or moderate disease. Half of patients presented with fever; however, in The Tibetan cohort, fever only occurred in 13.4% of patients. On hospital admission, proteinuria and dipstick hematuria were noted in 18.4% and 17.4% of patients, respectively, while AKI only occurred in one patient. Further analysis showed that severe or critical COVID-19 was associated with higher risk of proteinuria [relative risk (RR) 7.37, 95% confidence interval (CI) 2.45-22.18, P = 3.8 x 10(-4)] and dipstick hematuria (RR 8.30, 95% CI 2.69-25.56, P =2.3 x 10(-4)). Proteinuria, dipstick hematuria, or the combination of proteinuria and hematuria could significantly predict severe or critical se vere COVID-19.Conclusions. Proteinuria and dipstick hematuria are not uncommon in patients with COVID-19 infection, especially in severe or critical cases.