EHR data show kidney disease is strongest risk factor for COVID-19 hospitalizations
Through an analysis of electronic health record data, researchers from Geisinger determined patients with kidney disease are more likely to be hospitalized with COVID-19 vs. patients with other preexisting conditions.
“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,” Alex Chang, MD, a nephrologist at Geisinger and co-director of Geisinger's Kidney Health Research Institute, said in a related press release. “What is significant here is the magnitude of the kidney disease-related risk.”
For the study, researchers included 12,971 individuals who were tested for SARS-CoV-2 with pre-pandemic EHR data (1,604 individuals were SARS-CoV-2 positive; 354 individuals required hospitalization). They identified 21 clinical phenotypes in five disease categories (six of the phenotypes were kidney-related).
Results showed patients with end-stage kidney disease were 11 times more likely to be admitted to the hospital for COVID-19 than patients without kidney disease (OR = 11.07). Other kidney-related disorders were also associated with a high risk of hospitalization, with stage 4 CKD leading to an OR of 2.90, acute kidney failure to an OR of 3.26 and kidney transplant to an OR 14.98. For comparison, congestive heart failure conferred an OR of 3.8, chronic airway obstruction an OR of 2.54 and type 2 diabetes an OR 1.80.
Study co-investigator Tooraj Mirshahi, PhD, elaborated on the study design in the press release.
“Our team used a novel approach made possible by our extensive electronic health records, unique demographic data and integrated health system,” he said. “We were able to perform this study despite having a much lower number of COVID-19 cases compared to large hospitals in metropolitan areas.”
According to Chang, these results underscore “the need to prevent COVID-19-related illness in patients with kidney disease and other high-risk conditions."