![]() Both kits were used according to the manufacturer’s guidelines. RNAs were extracted using a commercial kit (BioSpeedy Nucleic Acid extraction kit Bioeksen R & D Technologies Ltd., Istanbul, Turkey), followed by the detection of COVID-19 RNA using a commercial RT-PCR kit (Bio-Speedy COVID-19 RT-qPCR kit Bioeksen R & D Technologies Ltd., Istanbul, Turkey) that targets the RdRP gene of COVID-19 in the samples. In cases who were followed with invasive mechanical ventilation in the intensive care unit (ICU), lower respiratory tract specimens were also obtained. Diagnostic methodologyĬombined pharyngeal and nasopharyngeal swab samples were obtained for the RT-PCR assay. *Definitions are based on the European Centre for Disease Prevention and Control. ![]() 10.1371/001 Fig 1 Flow chart showing the selection of the patients. Patients without any RT-PCR positivity, and those considered as ‘possible’ or ‘probable’ cases according to the Centers for Disease Control and Prevention (CDC) criteria were not included in the study ( Fig 1). The diagnosis of COVID-19 was confirmed with at least one positive real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test result in cases admitted with symptoms, signs and findings (laboratory / radiological) suggestive of COVID-19, according to the national guidelines. Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty hospital is one of the largest university hospitals in Istanbul, with a total of 897 hospital beds, 270 of which were allocated for the current pandemic. The study was conducted in a tertiary care university hospital in Istanbul, where approximately 60% of all cases in Turkey were reported. The source of medical records was ISHOP (Istanbul University-Cerrahpasa Hospital Automation Program) electronic database system. Medical records of consecutive adult (>18 years) patients hospitalized between March 15 and May 1, 2020, were reviewed outcomes data until June 1, 2020, were retrieved. The ethics committee waived the requirement for informed consent. The form of consent was not obtained because the data were analyzed anonymously. The study was conducted in accordance with the 1975 Declaration of Helsinki, as revised in 2013. The study protocol was approved by the Clinical Research Ethics Committee of Istanbul University Cerrahpasa (approval no: 2020–56318) and the Scientific Committee of the Ministry of Health (approval no: T13_09_11). In this study, we primarily aimed to investigate the effects of kidney function on the prognosis of COVID-19, exclusively focusing on the estimated glomerular filtration rate (eGFR) on admission, and secondarily to determine the rate of AKI in COVID-19 patients. However, formal studies that examine on admission kidney function on COVID-19 mortality is largely missing. It has also been recently shown that acute kidney injury (AKI) was related with mortality in coronavirus infections, including COVID-19. In line with this information, the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) suggested that CKD patients possess an increased risk for COVID-19 and related mortality. When compared to the general population, both the pneumonia risk and the mortality rate due to pneumonia are increased in patients with CKD. Ĭhronic kidney disease (CKD) is associated with alterations of innate and adaptive immunity. In severe cases, acute respiratory failure due to diffuse alveolar damage constitutes the main clinical characteristics of COVID-19, whereas kidneys are among the most common extrapulmonary targets of the virus. The first case of COVID-19 in Turkey was confirmed on March 10, 2020, and the World Health Organization declared the disease a pandemic on March 11. An outbreak of a novel coronavirus (severe acute respiratory syndrome coronavirus 2 also termed as COVID-19) has emerged from Wuhan city, China in December 2019 and spread to over 214 countries and territories worldwide within six months.
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