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.