With IRB approval, in this single-center, cross-sectional study, we reviewed 78 patients who were admitted to Labbafinezhad Hospital in Tehran from March 2, 2020, to May 9, 2020. This center is one of the major hospitals in Tehran, Iran, dealing with COVID-19 patients. Most of the patients had been screened due to the presence of clinical presentations attributable to COVID-19 including cough, fever, fatigue, myalgia, chest pain, dyspnea, other upper respiratory symptoms, and gastrointestinal symptoms. A few patients were asymptomatic, and their contraction was discovered accidentally. Diagnosis of COVID-19 patients was based on the WHO interim guidance, a confirmed COVID-19 patient defined as an individual with a positive reverse transcriptase-polymerase chain reaction (RT-PCR) result or a patient with common COVID-19 symptoms and a computed tomography scan (CT-scan) compatible to COVID-19 pattern confirmed by experts . Patients divided into 4 subgroups: 1) patients not on dialysis 2) patients on maintenance dialysis 3) patients underwent dialysis following COVID-19 and 4) patients with a history of a kidney transplant
The written informed consent form was obtained from all patients by the Ethics Commission of the hospital.
The study was approved by the ethical committee of Shahid Beheshti University of Medical Sciences (IR.SBMU.REC.1399.018) and all methods were performed in accordance with the relevant guidelines and regulations.
We reviewed clinical charts, nursing records, laboratory findings, and radiologic reports, and other medical records for all CKD patients with confirmed COVID-19 infection. Clinical presentations, laboratory data, radiological findings, and outcomes data were extracted by using data collection forms from documented medical records. Baseline information collected upon admission includes ID number, age, sex, history of a kidney transplant, underlying comorbidities, drug history, history of dialysis, presence of end-stage renal disease (ESRD) symptoms, laboratory data, vital signs, chest radiographic findings, and COVID-19 RT-PCR test. Mentioning that, laboratory tests were performed again, before discharge. It included complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), albumin, ferritin, fibrinogen, troponin, lactate dehydrogenase (LDH), blood urea nitrogen (BUN), creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine phosphokinase (CPK), and direct and indirect bilirubin.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was examined with RT-PCR for most of the patients. First, an oropharyngeal swab was used to collect samples from patients. Then, it was put into a 150 µL viral preservation solution. After total RNA extraction, reverse transcriptase-polymerase chain reaction (RT-PCR) was carried out to detect SARS-CoV-2. Detection of at least one of the specific genes, ORF1ab gene (nCovORF1ab) or the N gene (nCoV-NP), was considered as a positive test result. Some patients admitted with RT-PCR results from outside of the hospital.
Criteria for Quarantine Release and Discharge
The criteria for quarantine release and discharge consist of clinical improvement of symptoms and possessing normal and stable oxygen saturation (SpO2).
The collected data were summarized as descriptive profiles by using mean, median, standard deviation, and variance. The percentage, mean, median, standard deviation of patients was calculated within different groups for specific variables. Independent t-test, paired t-test, and chi-square were used to compare the clinical features of patients with COVID-19. A P. value of less than 0.05 was considered as indicating statistical significance. All the statistical analyses were performed by the Statistical Package for Social Sciences (SPSS Inc., Chicago, Illinois, USA) version 26.0.