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Article: Risk Factors and Outcomes of Acute Kidney Injury in Critically Ill Patients with Coronavirus Disease 2019.

Cheng, Yichun / Zhang, Nanhui / Luo, Ran / Zhang, Meng / Wang, Zhixiang / Dong, Lei / Li, Junhua / Zeng, Rui / Yao, Ying / Ge, Shuwang / Xu, Gang

Kidney diseases (Basel, Switzerland)

2020 Volume 7, Issue 2, Page(s) 111–119

Abstract: ... in-hospital mortality, and inflammatory response may play a role in AKI development in critically ill patients ... with a great number of deaths worldwide. Acute kidney injury (AKI) is a common complication in patients ... Background: Coronavirus disease 2019 (COVID-19) has emerged as a major global health threat ...

Abstract	Background: Coronavirus disease 2019 (COVID-19) has emerged as a major global health threat with a great number of deaths worldwide. Acute kidney injury (AKI) is a common complication in patients admitted to the intensive care unit. We aimed to assess the incidence, risk factors and in-hospital outcomes of AKI in COVID-19 patients admitted to the intensive care unit. Methods: We conducted a retrospective observational study in the intensive care unit of Tongji Hospital, which was assigned responsibility for the treatments of severe COVID-19 patients by the Wuhan government. AKI was defined and staged based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Mild AKI was defined as stage 1, and severe AKI was defined as stage 2 or stage 3. Logistic regression analysis was used to evaluate AKI risk factors, and Cox proportional hazards model was used to assess the association between AKI and in-hospital mortality. Results: A total of 119 patients with COVID-19 were included in our study. The median patient age was 70 years (interquartile range, 59-77) and 61.3% were male. Fifty-one (42.8%) patients developed AKI during hospitalization, corresponding to 14.3% in stage 1, 28.6% in stage 2 and 18.5% in stage 3, respectively. Compared to patients without AKI, patients with AKI had a higher proportion of mechanical ventilation mortality and higher in-hospital mortality. A total of 97.1% of patients with severe AKI received mechanical ventilation and in-hospital mortality was up to 79.4%. Severe AKI was independently associated with high in-hospital mortality (OR: 1.82; 95% CI: 1.06-3.13). Logistic regression analysis demonstrated that high serum interleukin-8 (OR: 4.21; 95% CI: 1.23-14.38), interleukin-10 (OR: 3.32; 95% CI: 1.04-10.59) and interleukin-2 receptor (OR: 4.50; 95% CI: 0.73-6.78) were risk factors for severe AKI development. Conclusions: Severe AKI was associated with high in-hospital mortality, and inflammatory response may play a role in AKI development in critically ill patients with COVID-19.
Language	English
Publishing date	2020-10-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2817963-8
ISSN	2296-9357 ; 2296-9381
ISSN (online)	2296-9357
ISSN	2296-9381
DOI	10.1159/000512270
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Risk Factors and Outcomes of Acute Kidney Injury in Critically Ill Patients with Coronavirus Disease 2019

Ge, Shuwang / Cheng, Yichun / Zhang, Nanhui / Luo, Ran / Zhang, Meng / Wang, Zhixiang / Dong, Lei / Li, Junhua / Zeng, Rui / Yao, Ying / Xu, Gang

Nephrology

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #855479
Database	COVID19

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Article ; Online: Risk Factors and Outcomes of Acute Kidney Injury in Critically Ill Patients with Coronavirus Disease 2019

Yichun Cheng / Nanhui Zhang / Ran Luo / Meng Zhang / Zhixiang Wang / Lei Dong / Junhua Li / Rui Zeng / Ying Yao / Shuwang Ge / Gang Xu

Kidney Diseases, Pp 1-

2020 Volume 9

Abstract: ... with a great number of deaths worldwide. Acute kidney injury (AKI) is a common complication in patients ... development in critically ill patients with COVID-19. ... Background: Coronavirus disease 2019 (COVID-19) has emerged as a major global health threat ...

Abstract	Background: Coronavirus disease 2019 (COVID-19) has emerged as a major global health threat with a great number of deaths worldwide. Acute kidney injury (AKI) is a common complication in patients admitted to the intensive care unit. We aimed to assess the incidence, risk factors and in-hospital outcomes of AKI in COVID-19 patients admitted to the intensive care unit. Methods: We conducted a retrospective observational study in the intensive care unit of Tongji Hospital, which was assigned responsibility for the treatments of severe COVID-19 patients by the Wuhan government. AKI was defined and staged based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Mild AKI was defined as stage 1, and severe AKI was defined as stage 2 or stage 3. Logistic regression analysis was used to evaluate AKI risk factors, and Cox proportional hazards model was used to assess the association between AKI and in-hospital mortality. Results: A total of 119 patients with COVID-19 were included in our study. The median patient age was 70 years (interquartile range, 59–77) and 61.3% were male. Fifty-one (42.8%) patients developed AKI during hospitalization, corresponding to 14.3% in stage 1, 28.6% in stage 2 and 18.5% in stage 3, respectively. Compared to patients without AKI, patients with AKI had a higher proportion of mechanical ventilation mortality and higher in-hospital mortality. A total of 97.1% of patients with severe AKI received mechanical ventilation and in-hospital mortality was up to 79.4%. Severe AKI was independently associated with high in-hospital mortality (OR: 1.82; 95% CI: 1.06–3.13). Logistic regression analysis demonstrated that high serum interleukin-8 (OR: 4.21; 95% CI: 1.23–14.38), interleukin-10 (OR: 3.32; 95% CI: 1.04–10.59) and interleukin-2 receptor (OR: 4.50; 95% CI: 0.73–6.78) were risk factors for severe AKI development. Conclusions: Severe AKI was associated with high in-hospital mortality, and inflammatory response may play a role in AKI development in critically ill patients with COVID-19.
Keywords	coronavirus disease 2019 ; acute kidney injury ; mortality ; risk factor ; Internal medicine ; RC31-1245
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	Karger Publishers
Document type	Article ; Online
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Article ; Online: Risk Factors and Outcomes of Acute Kidney Injury in Critically Ill Patients with Coronavirus Disease 2019

Cheng, Yichun / Zhang, Nanhui / Luo, Ran / Zhang, Meng / Wang, Zhixiang / Dong, Lei / Li, Junhua / Zeng, Rui / Yao, Ying / Ge, Shuwang / Xu, Gang

Kidney Diseases

2020 , Page(s) 1–9

Abstract: ... in patients admitted to the intensive care unit. We aimed to assess the incidence, risk factors and ... defined and staged based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Mild AKI was ... in AKI development in critically ill patients with COVID-19. ...

Abstract	*Background:* Coronavirus disease 2019 (COVID-19) has emerged as a major global health threat with a great number of deaths worldwide. Acute kidney injury (AKI) is a common complication in patients admitted to the intensive care unit. We aimed to assess the incidence, risk factors and in-hospital outcomes of AKI in COVID-19 patients admitted to the intensive care unit. *Methods:* We conducted a retrospective observational study in the intensive care unit of Tongji Hospital, which was assigned responsibility for the treatments of severe COVID-19 patients by the Wuhan government. AKI was defined and staged based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Mild AKI was defined as stage 1, and severe AKI was defined as stage 2 or stage 3. Logistic regression analysis was used to evaluate AKI risk factors, and Cox proportional hazards model was used to assess the association between AKI and in-hospital mortality. *Results:* A total of 119 patients with COVID-19 were included in our study. The median patient age was 70 years (interquartile range, 59–77) and 61.3% were male. Fifty-one (42.8%) patients developed AKI during hospitalization, corresponding to 14.3% in stage 1, 28.6% in stage 2 and 18.5% in stage 3, respectively. Compared to patients without AKI, patients with AKI had a higher proportion of mechanical ventilation mortality and higher in-hospital mortality. A total of 97.1% of patients with severe AKI received mechanical ventilation and in-hospital mortality was up to 79.4%. Severe AKI was independently associated with high in-hospital mortality (OR: 1.82; 95% CI: 1.06–3.13). Logistic regression analysis demonstrated that high serum interleukin-8 (OR: 4.21; 95% CI: 1.23–14.38), interleukin-10 (OR: 3.32; 95% CI: 1.04–10.59) and interleukin-2 receptor (OR: 4.50; 95% CI: 0.73–6.78) were risk factors for severe AKI development. *Conclusions:* Severe AKI was associated with high in-hospital mortality, and inflammatory response may play a role in AKI development in critically ill patients with COVID-19.
Keywords	covid19
Language	English
Publisher	S. Karger AG
Publishing country	ch
Document type	Article ; Online
ZDB-ID	2817963-8
ISSN	2296-9357 ; 2296-9381
ISSN (online)	2296-9357
ISSN	2296-9381
DOI	10.1159/000512270
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Article: Clinical Risk Factors for Mortality Among Critically Ill Mexican Patients With COVID-19.

Hernández-Cárdenas, Carmen M / Choreño-Parra, José Alberto / Torruco-Sotelo, Carlos / Jurado, Felipe / Serna-Secundino, Héctor / Aguilar, Cristina / García-Olazarán, José G / Hernández-García, Diana / Choreño-Parra, Eduardo M / Zúñiga, Joaquín / Lugo-Goytia, Gustavo

Frontiers in medicine

2021 Volume 8, Page(s) 699607

Abstract: Little literature exists about critically ill patients with coronavirus disease 2019 (COVID-19 ... pathogen. Two-thirds of COVID-19 patients developed acute kidney injury (AKIN). The mortality of our cohort ... phenotype and risk factors for mortality in mechanically ventilated Mexican patients with COVID-19. ...

Abstract	Little literature exists about critically ill patients with coronavirus disease 2019 (COVID-19) from Latin America. Here, we aimed to describe the clinical characteristics and mortality risk factors in mechanically ventilated COVID-19 patients from Mexico. For this purpose, we recruited 67 consecutive mechanically ventilated COVID-19 patients which were grouped according to their clinical outcome (survival vs. death). Clinical risk factors for mortality were identified by machine-learning and logistic regression models. The median age of participants was 42 years and 65% were men. The most common comorbidity observed was obesity (49.2%). Fever was the most frequent symptom of illness (88%), followed by dyspnea (84%). Multilobe ground-glass opacities were observed in 76% of patients by thoracic computed tomography (CT) scan. Fifty-two percent of study participants were ventilated in prone position, and 59% required cardiovascular support with norepinephrine. Furthermore, 49% of participants were coinfected with a second pathogen. Two-thirds of COVID-19 patients developed acute kidney injury (AKIN). The mortality of our cohort was 44.7%. AKIN, uric acid, lactate dehydrogenase (LDH), and a longitudinal increase in the ventilatory ratio were associated with mortality. Baseline PaO2/FiO2 values and a longitudinal recovery of lymphocytes were protective factors against mortality. Our study provides reference data about the clinical phenotype and risk factors for mortality in mechanically ventilated Mexican patients with COVID-19.
Language	English
Publishing date	2021-08-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2021.699607
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Article ; Online: Risk factors for severe and critically ill COVID-19 patients: A review.

Allergy

2020 Volume 76, Issue 2, Page(s) 428–455

Abstract: ... by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused an unprecedented global social and economic impact, and ... The pandemic of coronavirus disease 2019 (COVID-19), caused ... Possible complications include acute kidney injury, coagulation disorders, thoromboembolism ...

Abstract	The pandemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused an unprecedented global social and economic impact, and high numbers of deaths. Many risk factors have been identified in the progression of COVID-19 into a severe and critical stage, including old age, male gender, underlying comorbidities such as hypertension, diabetes, obesity, chronic lung diseases, heart, liver and kidney diseases, tumors, clinically apparent immunodeficiencies, local immunodeficiencies, such as early type I interferon secretion capacity, and pregnancy. Possible complications include acute kidney injury, coagulation disorders, thoromboembolism. The development of lymphopenia and eosinopenia are laboratory indicators of COVID-19. Laboratory parameters to monitor disease progression include lactate dehydrogenase, procalcitonin, high-sensitivity C-reactive protein, proinflammatory cytokines such as interleukin (IL)-6, IL-1β, Krebs von den Lungen-6 (KL-6), and ferritin. The development of a cytokine storm and extensive chest computed tomography imaging patterns are indicators of a severe disease. In addition, socioeconomic status, diet, lifestyle, geographical differences, ethnicity, exposed viral load, day of initiation of treatment, and quality of health care have been reported to influence individual outcomes. In this review, we highlight the scientific evidence on the risk factors of severity of COVID-19.
MeSH term(s)	COVID-19 ; Critical Illness ; Disease Progression ; Female ; Humans ; Male ; Risk Factors ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-12-04
Publishing country	Denmark
Document type	Journal Article ; Review
ZDB-ID	391933-x
ISSN	1398-9995 ; 0105-4538
ISSN (online)	1398-9995
ISSN	0105-4538
DOI	10.1111/all.14657
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Article ; Online: Clinical Risk Factors for Mortality Among Critically Ill Mexican Patients With COVID-19

Carmen M. Hernández-Cárdenas / José Alberto Choreño-Parra / Carlos Torruco-Sotelo / Felipe Jurado / Héctor Serna-Secundino / Cristina Aguilar / José G. García-Olazarán / Diana Hernández-García / Eduardo M. Choreño-Parra / Joaquín Zúñiga / Gustavo Lugo-Goytia

Frontiers in Medicine, Vol

2021 Volume 8

Abstract	Little literature exists about critically ill patients with coronavirus disease 2019 (COVID-19) from Latin America. Here, we aimed to describe the clinical characteristics and mortality risk factors in mechanically ventilated COVID-19 patients from Mexico. For this purpose, we recruited 67 consecutive mechanically ventilated COVID-19 patients which were grouped according to their clinical outcome (survival vs. death). Clinical risk factors for mortality were identified by machine-learning and logistic regression models. The median age of participants was 42 years and 65% were men. The most common comorbidity observed was obesity (49.2%). Fever was the most frequent symptom of illness (88%), followed by dyspnea (84%). Multilobe ground-glass opacities were observed in 76% of patients by thoracic computed tomography (CT) scan. Fifty-two percent of study participants were ventilated in prone position, and 59% required cardiovascular support with norepinephrine. Furthermore, 49% of participants were coinfected with a second pathogen. Two-thirds of COVID-19 patients developed acute kidney injury (AKIN). The mortality of our cohort was 44.7%. AKIN, uric acid, lactate dehydrogenase (LDH), and a longitudinal increase in the ventilatory ratio were associated with mortality. Baseline PaO2/FiO2 values and a longitudinal recovery of lymphocytes were protective factors against mortality. Our study provides reference data about the clinical phenotype and risk factors for mortality in mechanically ventilated Mexican patients with COVID-19.
Keywords	COVID-19 ; SARS-CoV-2 ; ARDS ; risk factors ; mortality ; Medicine (General) ; R5-920
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical characteristics and risk factors for 28-day mortality in critically ill patients with COVID-19: a retrospective cohort study

Yakar, Mehmet Nuri / Ergan, Begüm / Ergün, Bişar / Küçük, Murat / Cantürk, Ali / Ergon, Mahmut Cem / Gezer, Naciye Sinem / Yaka, Erdem / Cömert, Bilgin / Gökmen, Ali Necati

Turkish journal of medical sciences

2021 Volume 51, Issue 5, Page(s) 2285–2295

Abstract: ... detection of the risk factors and the use of chest CT score might improve the outcomes in patients ... critically ill patients (≥ 18 years) who were admitted to the intensive care unit due to COVID-19 were included ... Background: To date, the coronavirus disease 2019 (COVID-19) caused more than 2.6 million deaths ...

Abstract	Background: To date, the coronavirus disease 2019 (COVID-19) caused more than 2.6 million deaths all around the world. Risk factors for mortality remain unclear. The primary aim was to determine the independent risk factors for 28-day mortality. Materials and methods: In this retrospective cohort study, critically ill patients (≥ 18 years) who were admitted to the intensive care unit due to COVID-19 were included. Patient characteristics, laboratory data, radiologic findings, treatments, and complications were analyzed in the study. Results: A total of 249 patients (median age 71, 69.1% male) were included in the study. 28-day mortality was 67.9% (n = 169). The median age of deceased patients was 75 (66–81). Of them, 68.6% were male. Cerebrovascular disease, dementia, chronic kidney disease, and malignancy were significantly higher in the deceased group. In the multivariate analysis, sepsis/septic shock (OR, 15.16, 95% CI, 3.96–58.11, p < 0.001), acute kidney injury (OR, 4.73, 95% CI, 1.55–14.46, p = 0.006), acute cardiac injury (OR, 9.76, 95% CI, 1.84–51.83, p = 0.007), and chest CT score higher than 15 (OR, 4.49, 95% CI, 1.51-13.38, p = 0.007) were independent risk factors for 28-day mortality. Conclusion: Early detection of the risk factors and the use of chest CT score might improve the outcomes in patients with COVID-19.
MeSH term(s)	Aged ; Aged, 80 and over ; COVID-19/diagnosis ; COVID-19/mortality ; Cohort Studies ; Critical Illness ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2021-10-21
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	1183461-4
ISSN	1303-6165 ; 1300-0144
ISSN (online)	1303-6165
ISSN	1300-0144
DOI	10.3906/sag-2104-356
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Article: Predictive value of serum cystatin C for risk of mortality in severe and critically ill patients with COVID-19.

Li, Yan / Yang, Shuang / Peng, Ding / Zhu, Hong-Ming / Li, Bang-Yi / Yang, Xiaojiao / Sun, Xue-Lian / Zhang, Mei

World journal of clinical cases

2020 Volume 8, Issue 20, Page(s) 4726–4734

Abstract: ... of renal function. Early detection of risk factors that affect the prognosis of severe and critically ill patients ... Acute kidney injury is an independent risk factor for poor prognosis in patients with. Serum cystatin C (sCys C) is ... with COVID-19.: Methods: The clinical data of 101 severe and critically ill patients with COVID-19 ...

Abstract	Background: The outbreak of coronavirus disease 2019 (COVID-19) has rapidly evolved into a global pandemic. COVID-19 is clinically categorized into mild, moderate, severe, and critical illness. Acute kidney injury is an independent risk factor for poor prognosis in patients with. Serum cystatin C (sCys C) is considered a more sensitive biomarker for early renal insufficiency than conventional indicators of renal function. Early detection of risk factors that affect the prognosis of severe and critically ill patients while using active and effective treatment measures is very important and can effectively reduce the potential mortality rate. Aim: To determine the predictive value of sCys C for the prognosis of patients with COVID-19. Methods: The clinical data of 101 severe and critically ill patients with COVID-19 at a designated hospital in Wuhan, Hubei Province, China were analyzed retrospectively. According to the clinical outcome, the patients were divided into a discharge group (64 cases) and a death group (37 cases). The general information, underlying diseases, and laboratory examination indexes of the two groups were compared. Multivariate Cox regression was used to explore the relationship between sCys C and prognosis. The receiver operating characteristic (ROC) curve was used to demonstrate the sensitivity and specificity of sCys C and its optimal cut-off value for predicting death. Results: There were significant differences in age, sCys C, creatinine, C-reactive protein, serum albumin, creatine kinase-MB, alkaline phosphatase, lactate dehydrogenase, neutrophil count, and lymphocyte count between the two groups ( Conclusion: sCys C is an independent risk factor for death in patients with COVID-19. Patients with a sCys C level of 0.80 mg/L or greater are at a high risk of death.
Keywords	covid19
Language	English
Publishing date	2020-10-27
Publishing country	United States
Document type	Journal Article
ISSN	2307-8960
ISSN	2307-8960
DOI	10.12998/wjcc.v8.i20.4726
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Predictive value of serum cystatin C for risk of mortality in severe and critically ill patients with COVID-19

Li, Y. / Yang, S. / Peng, D. / Zhu, H. M. / Li, B. Y. / Yang, X. / Sun, X. L. / Zhang, M.

World Journal of Clinical Cases

Abstract: ... of renal function Early detection of risk factors that affect the prognosis of severe and critically ill patients ... Acute kidney injury is an independent risk factor for poor prognosis in patients with Serum cystatin C (sCys C) is ... METHODS: The clinical data of 101 severe and critically ill patients with COVID-19 at a designated ...

Abstract	BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) has rapidly evolved into a global pandemic COVID-19 is clinically categorized into mild, moderate, severe, and critical illness Acute kidney injury is an independent risk factor for poor prognosis in patients with Serum cystatin C (sCys C) is considered a more sensitive biomarker for early renal insufficiency than conventional indicators of renal function Early detection of risk factors that affect the prognosis of severe and critically ill patients while using active and effective treatment measures is very important and can effectively reduce the potential mortality rate AIM: To determine the predictive value of sCys C for the prognosis of patients with COVID-19 METHODS: The clinical data of 101 severe and critically ill patients with COVID-19 at a designated hospital in Wuhan, Hubei Province, China were analyzed retrospectively According to the clinical outcome, the patients were divided into a discharge group (64 cases) and a death group (37 cases) The general information, underlying diseases, and laboratory examination indexes of the two groups were compared Multivariate Cox regression was used to explore the relationship between sCys C and prognosis The receiver operating characteristic (ROC) curve was used to demonstrate the sensitivity and specificity of sCys C and its optimal cut-off value for predicting death RESULTS: There were significant differences in age, sCys C, creatinine, C-reactive protein, serum albumin, creatine kinase-MB, alkaline phosphatase, lactate dehydrogenase, neutrophil count, and lymphocyte count between the two groups (P < 0 001) Multivariate logistic regression analysis showed that sCys C was an independent risk factor for death in patients with COVID-19 (Odds ratio = 1 812, 95% confidence interval [CI]: 1 300-2 527, P < 0 001) The area under the ROC curve was 0 755 (95% CI: 1 300-2 527), the cut-off value was 0 80, the specificity was 0 562, and the sensitivity was 0 865 CONCLUSION: sCys C is an independent risk factor for death in patients with COVID-19 Patients with a sCys C level of 0 80 mg/L or greater are at a high risk of death
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #918544
Database	COVID19

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