In-hospital mortality and functional decline after COVID-19 versus other types of pneumonia in Japan: Effect of underlying kidney disease

Abstract

Abstract Coronavirus disease 2019 (COVID-19) affects both life and health. However, the differentiation from other types of pneumonia and effect of kidney disease remain uncertain. This retrospective observational study investigated the risk of in-hospital death and functional decline in ≥ 20% of Barthel Index scores after COVID-19 compared to other forms of pneumonia among Japanese adults, both with and without end-stage kidney disease (ESKD). The study enrolled 123,378 patients aged 18 years and older from a national inpatient administrative claims database in Japan that covers the first three waves of the COVID-19 pandemic in 2020. After a 1:1:1:1 propensity score matching into non-COVID-19/non-dialysis, COVID-19/non-dialysis, non-COVID-19/dialysis, and COVID-19/dialysis groups, 2,136 adults were included in the analyses. The multivariable logistic regression analyses revealed greater odds ratios (ORs) of death [5.92 (95% CI: 3.62–9.96)] and functional decline [1.93 (95% CI: 1.26–2.99)] only in the COVID-19/dialysis group versus the non-COVID-19/non-dialysis group. The COVID-19/dialysis group had a higher risk of death directly due to pneumonia (OR: 6.02, 95% CI: 3.50–10.8) or death due to other diseases (OR: 3.00, 95% CI: 1.11–8.48; versus the non-COVID-19/non-dialysis group). COVID-19 displayed a greater impact on the musculoskeletal system than other types of pneumonia particularly in ESKD.