Publication date: Jul 07, 2025

Background: Coronavirus disease 2019 (COVID-19) involves a complex interplay of dysregulated immune responses, a pro-inflammatory cytokine storm, endothelial injury, and thrombotic complications. This study aimed to evaluate the impact of kidney function on clinical, laboratory, and outcome parameters in patients hospitalized with COVID-19. Methods: We conducted a retrospective analysis of 359 patients admitted during the first wave of COVID-19, stratified by estimated glomerular filtration rate (eGFR < 60 vs. ≥60 mL/min/1. 73 m). Data on demographics, vital signs, laboratory values, and clinical outcomes-including mortality, hemodialysis requirement, intensive care unit (ICU) admission, and mechanical ventilation (MV)-were collected. Univariate and multivariate linear regression, as well as area under the receiver operating characteristic curve (AUC-ROC) analyses, were performed. A p-value < 0. 05 was considered statistically significant. Results: Patients with an eGFR < 60 were older and more likely to have systemic hypertension, chronic kidney disease, a history of solid organ transplantation, and immunosuppressive therapy. This group showed higher rates of mortality (41. 6% vs. 19. 2%), hemodialysis requirement (32. 3% vs. 9. 6%), ICU admission (50. 9% vs. 37. 9%), and MV (39. 8% vs. 21. 2%). Laboratory results revealed acidosis, anemia, lymphopenia, elevated inflammatory markers, and hyperkalemia. Conclusions: An admission eGFR < 60 mL/min/1. 73 m is associated with worse clinical outcomes in COVID-19 and may serve as a simple, early marker for risk stratification.

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