Clinical and laboratory features of patients with COVID-19 coronavirus pneumonia and changes in the general urine analysis

Aleksandrova S.G., Bychkova L.V., Aleksandrova M.R., Orlova A.M.

Backgraund: in 40% of patients with COVID-19, the development of kidney disease is described, from 10 to 15% of patients with pneumonia associated with COVID-19, kidney damage is also described, which, however, is not tracked in dynamics. Impaired kidney function in patients with a new coronavirus infection requires a change in the prescribed doses of medications, which makes it relevant to in-depth study of this group of patients to identify their characteristics.

Aims: to study the clinical and laboratory characteristics of patients with coronavirus pneumonia associated with COVID-19 and changes in urine tests.

Materials and methods: by the method of retrospective analysis, a group of patients who underwent inpatient treatment for pneumonia associated with COVID-19, occurring against the background of changes in urine tests, without a history of diseases of the urinary system.

Results: The study group of patients consisted of 103 patients with coronavirus pneumonia and changes in OAM, the comparison group consisted of 197 patients without changes in OAM. Coronavirus pneumonia with changes in OAM were significantly more common among males aged 18-59 years: 37 men and 15 women, respectively (p<0.001, chi-squared criterion). Changes in OAM were significantly more common in patients with moderate coronavirus pneumonia (CT 2): 19, 57, 15 and 12 patients with CT1-4, respectively (p<0.01, chi-squared criterion). In the patients of the study group, proteinuria significantly prevailed (93 (90.3%) patients) over leukocyturia (10 (9.7%) patients) (p<0.05, chi-squared criterion) and significantly more often had a minimal or moderate character (up to 0.9 g/l) — 53 (57%) of all cases of proteinuria (p<0.01), less often — massive (5 patients (5.4%) (p<0.01)); hematuria was not recorded in patients. There was a clear trend of prevalence of the number of cases of proteinuria in males in the study compared with women — 53 (51.4%) and 40 (38.8%) (p = 0.057, chi-squared criterion), which achieved reliability in the group of severe CT 4-9 (75%) men and 2 women (16.7%) (p < 0.05, chi-squared criterion). There was a significant increase in CRP values with an increase in CT severity (p = 0.017), while in women in CT groups 3 and 4, the mean values of CRP were significantly lower (p<0.05, t-Student criterion). Significantly, concomitant pathology was detected simultaneously in the study group — 65 (63.1%) and 38 (36.9%) patients without it (p<0.01, chi-squared criterion).

Conclusions: Clinical and laboratory features of the course of coronavirus pneumonia with changes in OAM have been established, a risk group for complications from the urinary system has been identified. These patients need dynamic monitoring after discharge from the hospital.Backgraund.

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