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Article ; Online: Acute Kidney Injury Incidence, Recovery, and Long-term Kidney Outcomes Among Hospitalized Patients With COVID-19 and Influenza.

Strohbehn, Ian A / Zhao, Sophia / Seethapathy, Harish / Lee, Meghan / Rusibamayila, Nifasha / Allegretti, Andrew S / Parada, Xavier Vela / Sise, Meghan E

Kidney international reports

2021  Volume 6, Issue 10, Page(s) 2565–2574

Abstract: ... We sought to compare the AKI incidence and outcomes among patients hospitalized with COVID-19 and ... and 13% in patients with COVID-19 and influenza, respectively. Compared with influenza, hospitalized ... patients were included; 1091 (45%) had COVID-19, and 1334 (55%) had influenza. The overall AKI rate was 23 ...

Abstract Introduction: Acute kidney injury (AKI) is a common complication in patients with severe COVID-19. We sought to compare the AKI incidence and outcomes among patients hospitalized with COVID-19 and with influenza.
Methods: This was a retrospective cohort study of patients with COVID-19 hospitalized between March and May 2020 and historical controls hospitalized with influenza A or B between January 2017 and December 2019 within a large health care system. Cox proportional hazards models were used to compare the risk of AKI during hospitalization. Secondary outcomes included AKI recovery, mortality, new-onset chronic kidney disease (CKD), and ≥25% estimated glomerular filtration rate (eGFR) decline.
Results: A total of 2425 patients were included; 1091 (45%) had COVID-19, and 1334 (55%) had influenza. The overall AKI rate was 23% and 13% in patients with COVID-19 and influenza, respectively. Compared with influenza, hospitalized patients with COVID-19 had an increased risk of developing AKI (adjusted hazard ratio [aHR] = 1.58; 95% confidence interval [CI], 1.29-1.94). Patients with AKI were more likely to die in the hospital when infected with COVID-19 versus influenza (aHR = 3.55; 95% CI, 2.11-5.97). Among patients surviving to hospital discharge, the rate of AKI recovery was lower in patients with COVID-19 (aHR = 0.47; 95% CI, 0.36-0.62); however, among patients followed for ≥90 days, new-onset CKD (aHR = 1.24; 95% CI, 0.86-1.78) and ≥25% eGFR decline at the last follow-up (aHR = 1.36, 95% CI, 0.97-1.90) were not significantly different between the cohorts.
Conclusion: AKI and mortality rates are significantly higher in patients with COVID-19 than influenza; however, kidney recovery among long-term survivors appears to be similar.
Language English
Publishing date 2021-07-15
Publishing country United States
Document type Journal Article
ISSN 2468-0249
ISSN (online) 2468-0249
DOI 10.1016/j.ekir.2021.07.008
Database MEDical Literature Analysis and Retrieval System OnLINE

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