INTRODUCTION
COVID-19 is a newly emerging human infectious disease of SARS-CoV-2
origin that is becoming a pandemic and has spread rapidly worldwide
[1]. This disease is highly contagious, with varied signs and
complications, and leads to a high risk to public health. The
predominant presentation of COVID-19 is an acute respiratory disease
that may progress to pneumonia; it may also damage other organs, for
instance, the kidneys, heart, gastrointestinal tract, liver, immune,
blood, and nervous system [2].
Most of the COVID-19 patients are presented with mild-to-moderate
respiratory manifestations and recovered with simple, supportive
treatment. Unfortunately, old patients, particularly those having
comorbidity such as diabetic, cardiovascular disease, COPD, cancer,
renal and hepatic diseases, are under higher risk of serious illness
[3]. Acute kidney injury (AKI) and liver injury are common in
patients with COVID-19 and plays a vital role in the duration of therapy
and clinical outcome [4].
Many studies confirm that AKI is the most critical complications of
COVID-19 and the incidence was 11.6% of Chinese adult hospitalized with
COVID-19 and was higher (>50%) for patients in the
intensive care unit (ICU) [5]. Moreover, other studies have shown
that 17% of COVID-19 patients might develop AKI and the mortality rate
was higher for such patients [6].
The liver is not affected directly, as it seems to be spared by the
virus; however, cytokine storm in patients with the most severe form of
the disease might cause liver injury. Liver injury, in the form of
hepatitis and/or cholestasis, is commonly observed in up to 60% of
patients suffering from SARS [7]. Moreover, studies suggested that
the change in hepatic biochemistry might result from pneumonia-induced
hypoxaemia, drug-induced hepatotoxicity and systemic inflammatory
response, particularly for COVID-19 patients hospitalized with severe
manifestation [8].
One of the critical prognostic factors for COVID-19 patients survival is
the development of AKI and hepatic injury. However, unlike other
identified prognostic factors, AKI and hepatic injury are possibly
curable by interventions [9].
Our objective was to identify the association between markers of kidney
and liver disease with the death in patients infected with SARS-CoV-2.