Predictive Factors of Renal Failure in COVID-19 Patients at the Anti-COVID Center in Lome, Togo

Abstract

Background : Angiotensin-converting enzyme 2 has been identified as the receptor that allows the entry of SarsCov2 into the human cell. Its expression in the kidney is 100 times higher than in the lung; thus, making the kidney an excellent target for SarsCov2 infection manifesting as renal failure (RF). The objective of this study was to determine the predictive factors of RF during COVID-19 in the Togolese context. Patients and Methods: This was a retrospective descriptive and analytical study conducted at the Lomé Anti-COVID Center including the records of patients hospitalized for COVID-19, of age ≥ 18 years and having performed a creatinemia. RF was defined by a GFR < 60 ml/min/1.73m 2 calculated according to the MDRD formula. Patients were randomized into 2 groups according to GFR<60 or not. Statistical tests used were Pearson’s Chi-2 test or Fisher’s exact test for qualitative variables and Mann-Whitney test or Wilcoxon test for quantitative variables. The significance level was set at 0.05. Univariate and multivariate logistic regression was performed to search for associated factors. Results : 482 patients were selected for this study with a mean age of 58.02 years. Sixty-five percent of the patients were men, i.e. , a sex ratio of 1.88. Fifty-two patients had RF, i.e. , a frequency of 10.8%.There were 65% men (315 cases), for a sex ratio (M/F) of 1.88. Risk factors for renal failure in COVID-19 were age ≥ 65 years (ORa 2.42; CIa95% [1.17 - 4.95]; p = 0.016), anemia (ORa 2.49; CIa95% [1.21 - 5.26]; p = 0.015), moderate (ORa 13; CIa95% [2.30 - 2.44]; p = 0.017), severe (ORa 26.2; CIa95% [4.85 - 4.93]; p = 0.002) and critical (ORa 108; CIa95% [16.5 - 21.76]; p < 0.001) severity stages at admission. Conclusion : Renal failure would therefore be related to the severity of COVID-19 and is the most formidable factor, conditioning the course of the disease and the patient’s vital prognosis.