MO152: SARS-COV-2 Infection and Kidney Impairment

Abstract BACKGROUND AND AIMS The objectives of the present study are to compare the renal impairment between patients with SARS-COV-2 in two different time periods with dominant beta and delta SARS-COV-2 variants, with or without prior chronic kidney disease (CKD). METHOD The study was performed on 80 patients from Bucharest Emergency University Hospital, Nephrology ward, 40 out of 80 patients were diagnosed with SARS-COV-2, beta variant dominant and 40 were diagnosed with SARS-COV-2 delta variant dominant. All patients were confirmed with SARS-COV-2 infection with positive PCR tests.  In order to assess the renal function for the patients with beta and delta variant of SARS-COV-2, the values of urea, creatinine, sodium, potassium, calcium, phosphorus and haemoglobin were observed during their hospitalization. Only 4 out of 40 patients with beta variant (10%) had documented pre-existing CKD. The average period of hospitalization was 14 days, with three exceptions (7.5%) in which due to the advancement of acute respiratory failure patients were transferred to the ICU. Only 3 out of 40 patients with delta variant (7.5%) were diagnosed with acute kidney injury (AKI). Average period of hospitalization was 14 days, with three exceptions (7.5%) in which due to the advancement of acute respiratory failure patients was transferred to the ICU. RESULTS In 36 out of 40 patients (90%) with beta variant dominant of SARS-COV-2, the analysis of biological parameters shows a minimal change in their values during hospitalization with normal maintenance of renal function. In two patients (5%), diagnosed with CKD, an average of three to four haemodialysis sessions were performed with the improvement of renal function, while maintaining a minimum nitrogen retention. In two patients with CKD (5%), renal function depreciated, leading to haemodialysis initiation.  In 33 out of 40 patients (82.5%) with delta variant dominant of SARS-COV-2, the analysis of biological parameters shows a minimal change in their values during hospitalization with normal maintenance of renal function. In 4 out of 40 patients (10%), the renal function depreciated in context of multiple system organ failure (MSOF), and subsequently they died. During hospitalization, in three patients (7.5%) who were admitted with AKI, the renal disfunction was resolved by the time of their discharge.  There were no statistically relevant differences (P > .1) in measured parameters between the two time periods with the different SARS-COV-2 strings. CONCLUSION According to this statistical analysis, the delta variant does not cause more kidney damage than the beta variant of SARS-COV-2. For the six patients (7.5%) with renal impairment, two from the beta batch (2.5%) and four from the delta batch (5%), the suspicion of renal damage in SARS-COV-2 infection may be raised, but excluding other causes of renal damage is necessary. For the three patients (7.5%) with AKI from the delta batch, the suspicion of renal damage caused by COVID-19 may be raised because there were no other causes for renal impairment.