PURPOSE: To qualitatively and quantitatively assess kidney imapairment in adults with COVID-19 by analysing imaging features on non-enhanced CT (NECT) and possible correlation between renal parenchymal attenuation (RPA) and serum creatinine (SCr) levels on admission .
METHODS: This study was approved by the local institutional ethics committee . A total of 82 patients with COVID-19 admitted from 10/1/2020â¼15/3/2020 were enrolled . RPA and perinephric fat stranding (PFS) were evaluated on NECT imaging . According to the presence of PFS, the patients were divided into two groups: Group A , 38 patients with PFS, and Group B , 44 patients without PFS . Clinical data, including age, gender, clinical classification, SCr levels, and RPA on NECT were analysed . The RPA and SCr of the two groups with COVID-19 were analysed to determine possible difference and correlation . Eighty subjects with no kidney diseases were randomly selected as control group to determine the RPA of normal kidney performed on the same CT scanner .
RESULTS: Mean age, male to female ratio, number of severe and critical cases, and SCr of Group A were higher than those of Group B . Both mean RPA of Group A and Group B were lower than that of control . Mean RPA of Group A was even lower than that of Group B . A significant weak negative linear correlation between RPA on NECT and SCr in COVID-19 was indicated .
CONCLUSIONS: Decrease in RPA on NECT was observed in patients with COVID-19 and a weak linear negative correlation with SCr levels was found . The presence of PFS suggested more severe renal impairment in COVID-19 . RPA measurements and PFS could be useful in quantitative and qualitative evaluation of COVID-19 associated renal impairment on admission.