Impact of chronic kidney disease on the course and outcome of COVID-19

COVID-19 is primarily a respiratory disease. However, patients with COVID-19 are at high risk for acute kidney injury or exacerbation of preexisting kidney disease, especially those with comorbidities such as hypertension, coronary artery disease, chronic liver disease, chronic kidney disease, and malignancies. We reviewed studies that assessed the association between chronic kidney disease and SARS-CoV-2 coronavirus infection and infection outcomes, including hospitalization, severe COVID-19, need for intensive care, COVID-19 progression, and death. The studies showed varied and often contradictory results, as the baseline data differ in many parameters, such as the period of the pandemic, quality and size of the sample, and degree of comorbidity. Nevertheless, the studies consistently revealed that chronic kidney disease is an unfavorable factor with regard to SARS-CoV-2 infection. Furthermore, concomitant chronic kidney disease predisposes patients with COVID-19 to severe COVID-19, viral pneumonia, development of acute respiratory distress syndrome, acute kidney injury, and other complications, which in turn are negative prognostic factors for mortality. Patients with chronic kidney disease who survived COVID-19 are more likely to develop post-COVID syndromes with various persistent or recurrent symptoms than convalescents without renal comorbidity. These patients require long-term monitoring and optimization of therapy and are priority for vaccination.