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

Author(s): Kossi Akomola SABI, Awéréou KOTOSSO, Yoan Makafui AMEKOUDI, Laune Odilon BLATOME, Badomta DOLAAMA, Ayodélé Jonathan SABI, Oscar GNIRIMI GBAHBANG, Loutou Ahoub-Laye AFFO

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/1.73 m2 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.