Article ; Online: Association of SARS-CoV-2 viral load at admission with in-hospital acute kidney injury: A retrospective cohort study.
PloS one
2021 Volume 16, Issue 2, Page(s) e0247366
Abstract: ... SARS-CoV-2 viral load (VL) to AKI. We explored the association of SARS-CoV-2 VL at admission to AKI ... may be a direct effect of SARS-CoV-2 virus on the kidney; however, there is currently no data linking ... Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated ...
| Abstract | Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated Coronavirus Disease 2019 (COVID-19) is a public health emergency. Acute kidney injury (AKI) is a common complication in hospitalized patients with COVID-19 although mechanisms underlying AKI are yet unclear. There may be a direct effect of SARS-CoV-2 virus on the kidney; however, there is currently no data linking SARS-CoV-2 viral load (VL) to AKI. We explored the association of SARS-CoV-2 VL at admission to AKI in a large diverse cohort of hospitalized patients with COVID-19. Methods and findings: We included patients hospitalized between March 13th and May 19th, 2020 with SARS-CoV-2 in a large academic healthcare system in New York City (N = 1,049) with available VL at admission quantified by real-time RT-PCR. We extracted clinical and outcome data from our institutional electronic health records (EHRs). AKI was defined by KDIGO guidelines. We fit a Fine-Gray competing risks model (with death as a competing risk) using demographics, comorbidities, admission severity scores, and log10 transformed VL as covariates and generated adjusted hazard ratios (aHR) and 95% Confidence Intervals (CIs). VL was associated with an increased risk of AKI (aHR = 1.04, 95% CI: 1.01-1.08, p = 0.02) with a 4% increased hazard for each log10 VL change. Patients with a viral load in the top 50th percentile had an increased adjusted hazard of 1.27 (95% CI: 1.02-1.58, p = 0.03) for AKI as compared to those in the bottom 50th percentile. Conclusions: VL is weakly but significantly associated with in-hospital AKI after adjusting for confounders. This may indicate the role of VL in COVID-19 associated AKI. This data may inform future studies to discover the mechanistic basis of COVID-19 associated AKI. |
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| MeSH term(s) | Acute Kidney Injury/metabolism ; Acute Kidney Injury/virology ; Adult ; Aged ; Aged, 80 and over ; COVID-19/metabolism ; COVID-19/mortality ; COVID-19/virology ; Cohort Studies ; Comorbidity ; Female ; Hospital Mortality ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; New York City/epidemiology ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; SARS-CoV-2/isolation & purification ; Viral Load |
| Language | English |
| Publishing date | 2021-02-24 |
| Publishing country | United States |
| Document type | Journal Article |
| ISSN | 1932-6203 |
| ISSN (online) | 1932-6203 |
| DOI | 10.1371/journal.pone.0247366 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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