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Article ; Online: Acute kidney injury and mortality risk in older adults with COVID-19.

Xu, Hong / Garcia-Ptacek, Sara / Annetorp, Martin / Bruchfeld, Annette / Cederholm, Tommy / Johnson, Peter / Kivipelto, Miia / Metzner, Carina / Religa, Dorota / Eriksdotter, Maria

Journal of nephrology

2021 Volume 34, Issue 2, Page(s) 295–304

Abstract: Background: Research regarding COVID-19 and acute kidney injury (AKI) in older adults is scarce ... We evaluated risk factors and outcomes of AKI in hospitalized older adults with and without COVID-19 ... hospitalized for other diagnoses. COVID-19 and reduced baseline kidney function were risk ...

Abstract	Background: Research regarding COVID-19 and acute kidney injury (AKI) in older adults is scarce. We evaluated risk factors and outcomes of AKI in hospitalized older adults with and without COVID-19. Methods: Observational study of patients admitted to two geriatric clinics in Stockholm from March 1st to June 15th, 2020. The difference in incidence, risk factors and adverse outcomes for AKI between patients with or without COVID-19 were examined. Odds ratios (OR) for the risk of AKI and in-hospital death were obtained from logistic regression. Results: Three hundred-sixteen older patients were hospitalized for COVID-19 and 876 patients for non-COVID-19 diagnoses. AKI occurred in 92 (29%) patients with COVID-19 vs. 159 (18%) without COVID-19. The odds for developing AKI were higher in patients with COVID-19 (adjusted OR, 1.70; 95% confidence interval [CI] 1.04-2.76), low baseline kidney function as depicted by estimated glomerular filtration rate (eGFR) [4.19 (2.48-7.05), for eGFR 30 to < 60 mL/min, and 20.3 (9.95-41.3) for eGFR < 30 mL/min], and higher C reactive protein (CRP) (OR 1.81 (1.11-2.95) in patients with initial CRP > 10 mg/L). Compared to patients without COVID-19 and without AKI, the risk of in-hospital death was highest in patients with COVID-19 and AKI [OR 80.3, 95% CI (27.3-235.6)], followed by COVID-19 without AKI [16.3 (6.28-42.4)], and by patients without COVID-19 and with AKI [10.2 (3.66-28.2)]. Conclusions: Geriatric patients hospitalized with COVID-19 had a higher incidence of AKI compared to patients hospitalized for other diagnoses. COVID-19 and reduced baseline kidney function were risk factors for developing AKI. AKI and COVID-19 were associated with in-hospital death.
MeSH term(s)	Acute Kidney Injury/etiology ; Acute Kidney Injury/mortality ; Aged, 80 and over ; COVID-19/complications ; COVID-19/epidemiology ; Female ; Hospital Mortality/trends ; Humans ; Incidence ; Male ; Pandemics ; Retrospective Studies ; Risk Assessment/methods ; Risk Factors ; Survival Rate/trends ; Sweden/epidemiology
Language	English
Publishing date	2021-03-22
Publishing country	Italy
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1093991-x
ISSN	1724-6059 ; 1120-3625 ; 1121-8428
ISSN (online)	1724-6059
ISSN	1120-3625 ; 1121-8428
DOI	10.1007/s40620-021-01022-0
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Article ; Online: Regional variation of COVID-19 admissions, acute kidney injury and mortality in England - a national observational study using administrative data.

Kolhe, Nitin V / Fluck, Richard J / Taal, Maarten W

BMC infectious diseases

2024 Volume 24, Issue 1, Page(s) 346

Abstract: ... in-hospital mortality, and acute kidney injury (AKI) in England. We investigated the influence of population demographic ... logistic regression identified factors predicting AKI and mortality in COVID-19 hospitalized patients.: Results ... Background: This study explores regional variations in COVID-19 hospitalization rates ...

Abstract	Background: This study explores regional variations in COVID-19 hospitalization rates, in-hospital mortality, and acute kidney injury (AKI) in England. We investigated the influence of population demographic characteristics, viral strain changes, and therapeutic advances on clinical outcomes. Methods: Using hospital episode statistics, we conducted a retrospective cohort study with 749,844 admissions in 337,029 adult patients with laboratory-confirmed COVID-19 infection (March 1, 2020, to March 31, 2021). Multivariable logistic regression identified factors predicting AKI and mortality in COVID-19 hospitalized patients. Results: London had the highest number of COVID-19 admissions (131,338, 18%), followed by the North-west region (122,683, 16%). The North-west had the highest population incidence of COVID-19 hospital admissions (21,167 per million population, pmp), while the South-west had the lowest (9,292 admissions pmp). Patients in London were relatively younger (67.0 ± 17.7 years) than those in the East of England (72.2 ± 16.8 years). The shortest length of stay was in the North-east (12.2 ± 14.9 days), while the longest was in the North-west (15.2 ± 17.9 days). All eight regions had higher odds of death compared to London, ranging from OR 1.04 (95% CI 1.00, 1.07) in the South-west to OR 1.24 (95% CI 1.21, 1.28) in the North-west. Older age, Asian ethnicity, emergency admission, transfers from other hospitals, AKI presence, ITU admission, social deprivation, and comorbidity were associated with higher odds of death. AKI incidence was 30.3%, and all regions had lower odds of developing AKI compared to London. Increasing age, mixed and black ethnicity, emergency admission, transfers from other providers, ITU care, and different levels of comorbidity were associated with higher odds of developing AKI. Conclusions: London exhibited higher hospital admission numbers and AKI incidence, but lower odds of death compared to other regions in England. Trial registration: Registered on National Library of Medicine website ( www. Clinicaltrials: gov ) with registration number NCT04579562 on 8/10/2020.
MeSH term(s)	Adult ; Humans ; COVID-19/epidemiology ; Retrospective Studies ; Hospitalization ; England/epidemiology ; Acute Kidney Injury ; Hospital Mortality ; Risk Factors
Language	English
Publishing date	2024-03-22
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	2041550-3
ISSN	1471-2334 ; 1471-2334
ISSN (online)	1471-2334
ISSN	1471-2334
DOI	10.1186/s12879-024-09210-6
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Article ; Online: Epidemiology and Outcomes of Acute Kidney Injury in COVID-19 Patients with Acute Respiratory Distress Syndrome: A Multicenter Retrospective Study.

Wang, Feilong / Ran, Linyu / Qian, Chenchen / Hua, Jing / Luo, Zhibing / Ding, Min / Zhang, Xing / Guo, Wei / Gao, Shaoyong / Gao, Weibo / Li, Chaoping / Liu, Zhongmin / Li, Qiang / Ronco, Claudio

Blood purification

2020 Volume 50, Issue 4-5, Page(s) 499–505

Abstract: Background: Acute kidney injury (AKI) is associated with increased mortality in patients ... in-hospital mortality were investigated.: Results: A total of 275 COVID-19 patients with ARDS were included ... among COVID-19 patients with ARDS are unknown.: Methods: We retrospectively recruited consecutive adult ...

Abstract	Background: Acute kidney injury (AKI) is associated with increased mortality in patients with acute respiratory distress syndrome (ARDS). However, the epidemiological features and outcomes of AKI among COVID-19 patients with ARDS are unknown. Methods: We retrospectively recruited consecutive adult COVID-19 patients who were diagnosed with ARDS according to Berlin definition from 13 designated intensive care units in the city of Wuhan, China. Potential risk factors of AKI as well as the relation between AKI and in-hospital mortality were investigated. Results: A total of 275 COVID-19 patients with ARDS were included in the study, and 49.5% of them developed AKI during their hospital stay. In comparison with patients without AKI, patients who developed AKI were older, tended to have chronic kidney disease, had higher Sepsis-Related Organ Failure Assessment score on day 1, and were more likely to receive invasive ventilation and develop acute organ dysfunction. Multivariate analysis showed that age, history of chronic kidney disease, neutrophil-to-lymphocyte ratio, and albumin level were independently associated with the occurrence of AKI. Importantly, increasing AKI severity was associated with increased in-hospital mortality when adjusted for other potential variables: odds ratio of stage 1 = 5.374 (95% CI: 2.147-13.452; p < 0.001), stage 2 = 6.216 (95% CI: 2.011-19.210; p = 0.002), and stage 3 = 34.033 (95% CI: 9.723-119.129; p < 0.001). Conclusion: In this multicenter retrospective study, we found that nearly half of COVID-19 patients with ARDS experienced AKI during their hospital stay. The coexistence of AKI significantly increased the mortality of these patients.
MeSH term(s)	Acute Kidney Injury/blood ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; Aged ; COVID-19/complications ; China/epidemiology ; Comorbidity ; Creatinine/blood ; Female ; Hospital Mortality ; Humans ; Intensive Care Units/statistics & numerical data ; Male ; Middle Aged ; Renal Insufficiency, Chronic/complications ; Respiration, Artificial/adverse effects ; Respiration, Artificial/statistics & numerical data ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/therapy ; Retrospective Studies ; Risk Factors ; SARS-CoV-2
Chemical Substances	Creatinine (AYI8EX34EU)
Language	English
Publishing date	2020-12-08
Publishing country	Switzerland
Document type	Journal Article ; Multicenter Study
ZDB-ID	605548-5
ISSN	1421-9735 ; 0253-5068
ISSN (online)	1421-9735
ISSN	0253-5068
DOI	10.1159/000512371
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Article ; Online: SARS-CoV-2 infection increases risk of acute kidney injury in a bimodal age distribution.

Bjornstad, Erica C / Cutter, Gary / Guru, Pramod / Menon, Shina / Aldana, Isabella / House, Scott / M Tofil, Nancy / St Hill, Catherine A / Tarabichi, Yasir / Banner-Goodspeed, Valerie M / Christie, Amy B / Mohan, Surapaneni Krishna / Sanghavi, Devang / Mosier, Jarrod M / Vadgaonkar, Girish / Walkey, Allan J / Kashyap, Rahul / Kumar, Vishakha K / Bansal, Vikas /

Boman, Karen / Sharma, Mayank / Bogojevic, Marija / Deo, Neha / Retford, Lynn / Gajic, Ognjen / Gist, Katja M

BMC nephrology

2022 Volume 23, Issue 1, Page(s) 63

Abstract: ... linear, logistic and generalized estimating equations assessed odds ratios (OR), risk differences (RD ... and 95% confidence intervals (CIs) for AKI and mortality adjusting for sex, pre-existing comorbidities ... Background: Hospitalized patients with SARS-CoV2 develop acute kidney injury (AKI) frequently ...

Abstract	Background: Hospitalized patients with SARS-CoV2 develop acute kidney injury (AKI) frequently, yet gaps remain in understanding why adults seem to have higher rates compared to children. Our objectives were to evaluate the epidemiology of SARS-CoV2-related AKI across the age spectrum and determine if known risk factors such as illness severity contribute to its pattern. Methods: Secondary analysis of ongoing prospective international cohort registry. AKI was defined by KDIGO-creatinine only criteria. Log-linear, logistic and generalized estimating equations assessed odds ratios (OR), risk differences (RD), and 95% confidence intervals (CIs) for AKI and mortality adjusting for sex, pre-existing comorbidities, race/ethnicity, illness severity, and clustering within centers. Sensitivity analyses assessed different baseline creatinine estimators. Results: Overall, among 6874 hospitalized patients, 39.6% (n = 2719) developed AKI. There was a bimodal distribution of AKI by age with peaks in older age (≥60 years) and middle childhood (5-15 years), which persisted despite controlling for illness severity, pre-existing comorbidities, or different baseline creatinine estimators. For example, the adjusted OR of developing AKI among hospitalized patients with SARS-CoV2 was 2.74 (95% CI 1.66-4.56) for 10-15-year-olds compared to 30-35-year-olds and similarly was 2.31 (95% CI 1.71-3.12) for 70-75-year-olds, while adjusted OR dropped to 1.39 (95% CI 0.97-2.00) for 40-45-year-olds compared to 30-35-year-olds. Conclusions: SARS-CoV2-related AKI is common with a bimodal age distribution that is not fully explained by known risk factors or confounders. As the pandemic turns to disproportionately impacting younger individuals, this deserves further investigation as the presence of AKI and SARS-CoV2 infection increases hospital mortality risk.
MeSH term(s)	Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Adolescent ; Adult ; Age Distribution ; Age Factors ; Aged ; Aged, 80 and over ; COVID-19/complications ; COVID-19/epidemiology ; Child ; Child, Preschool ; Comorbidity ; Confidence Intervals ; Creatinine/blood ; Global Health/statistics & numerical data ; Hospital Mortality ; Humans ; Inpatients/statistics & numerical data ; Middle Aged ; Odds Ratio ; Registries/statistics & numerical data ; SARS-CoV-2 ; Severity of Illness Index
Chemical Substances	Creatinine (AYI8EX34EU)
Language	English
Publishing date	2022-02-11
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-022-02681-2
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Article ; Online: Acute kidney injury associated with COVID-19: A retrospective cohort study.

Kolhe, Nitin V / Fluck, Richard J / Selby, Nicholas M / Taal, Maarten W

PLoS medicine

2020 Volume 17, Issue 10, Page(s) e1003406

Abstract: ... AKI. Mortality was higher in COVID-19 AKI versus COVID-19 patients without AKI (60.5% versus 27.4%, p ... hospital acquired (61.2% versus 46.4%, p < 0.001). Mortality was higher in the COVID-19 AKI as compared ... Disease 2019 (COVID-19), but more data are required to clarify if COVID-19 is an independent risk ...

Abstract	Background: Initial reports indicate a high incidence of acute kidney injury (AKI) in Coronavirus Disease 2019 (COVID-19), but more data are required to clarify if COVID-19 is an independent risk factor for AKI and how COVID-19-associated AKI may differ from AKI due to other causes. We therefore sought to study the relationship between COVID-19, AKI, and outcomes in a retrospective cohort of patients admitted to 2 acute hospitals in Derby, United Kingdom. Methods and findings: We extracted electronic data from 4,759 hospitalised patients who were tested for COVID-19 between 5 March 2020 and 12 May 2020. The data were linked to electronic patient records and laboratory information management systems. The primary outcome was AKI, and secondary outcomes included in-hospital mortality, need for ventilatory support, intensive care unit (ICU) admission, and length of stay. As compared to the COVID-19-negative group (n = 3,374), COVID-19 patients (n = 1,161) were older (72.1 ± 16.1 versus 65.3 ± 20.4 years, p < 0.001), had a greater proportion of men (56.6% versus 44.9%, p < 0.001), greater proportion of Asian ethnicity (8.3% versus 4.0%, p < 0.001), and lower proportion of white ethnicity (75.5% versus 82.5%, p < 0.001). AKI developed in 304 (26.2%) COVID-19-positive patients (COVID-19 AKI) and 420 (12.4%) COVID-19-negative patients (AKI controls). COVID-19 patients aged 65 to 84 years (odds ratio [OR] 1.67, 95% confidence interval [CI] 1.11 to 2.50), needing mechanical ventilation (OR 8.74, 95% CI 5.27 to 14.77), having congestive cardiac failure (OR 1.72, 95% CI 1.18 to 2.50), chronic liver disease (OR 3.43, 95% CI 1.17 to 10.00), and chronic kidney disease (CKD) (OR 2.81, 95% CI 1.97 to 4.01) had higher odds for developing AKI. Mortality was higher in COVID-19 AKI versus COVID-19 patients without AKI (60.5% versus 27.4%, p < 0.001), and AKI was an independent predictor of mortality (OR 3.27, 95% CI 2.39 to 4.48). Compared with AKI controls, COVID-19 AKI was observed in a higher proportion of men (58.9% versus 51%, p = 0.04) and lower proportion with white ethnicity (74.7% versus 86.9%, p = 0.003); was more frequently associated with cerebrovascular disease (11.8% versus 6.0%, p = 0.006), chronic lung disease (28.0% versus 19.3%, p = 0.007), diabetes (24.7% versus 17.9%, p = 0.03), and CKD (34.2% versus 20.0%, p < 0.001); and was more likely to be hospital acquired (61.2% versus 46.4%, p < 0.001). Mortality was higher in the COVID-19 AKI as compared to the control AKI group (60.5% versus 27.6%, p < 0.001). In multivariable analysis, AKI patients aged 65 to 84 years, (OR 3.08, 95% CI 1.77 to 5.35) and ≥85 years of age (OR 3.54, 95% CI 1.87 to 6.70), peak AKI stage 2 (OR 1.74, 95% CI 1.05 to 2.90), AKI stage 3 (OR 2.01, 95% CI 1.13 to 3.57), and COVID-19 (OR 3.80, 95% CI 2.62 to 5.51) had higher odds of death. Limitations of the study include retrospective design, lack of urinalysis data, and low ethnic diversity of the region. Conclusions: We observed a high incidence of AKI in patients with COVID-19 that was associated with a 3-fold higher odds of death than COVID-19 without AKI and a 4-fold higher odds of death than AKI due to other causes. These data indicate that patients with COVID-19 should be monitored for the development of AKI and measures taken to prevent this. Trial registration: ClinicalTrials.gov NCT04407156.
MeSH term(s)	Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Acute Kidney Injury/mortality ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Betacoronavirus ; COVID-19 ; Comorbidity ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Coronavirus Infections/virology ; Ethnicity ; Female ; Hospital Mortality ; Hospitalization ; Humans ; Incidence ; Intensive Care Units ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; Pneumonia, Viral/virology ; Renal Insufficiency, Chronic/complications ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; United Kingdom/epidemiology ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-10-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2185925-5
ISSN	1549-1676 ; 1549-1277
ISSN (online)	1549-1676
ISSN	1549-1277
DOI	10.1371/journal.pmed.1003406
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Article ; Online: Acute kidney injury, a common and severe complication in hospitalized patients during the COVID-19 pandemic.

Scarpioni, Roberto / Valsania, Teresa / Albertazzi, Vittorio / Blanco, Valentina / DeAmicis, Sara / Manini, Alessandra / Melfa, Luigi / Ricardi, Marco / Rocca, Chiara / Gandolfi, Stefano

Journal of nephrology

2021 Volume 34, Issue 4, Page(s) 1019–1024

Abstract: ... 2019 (COVID-19), but little is known about the outcome of acute kidney injury (AKI) associated with ARF ... with those without AKI (p < 0.01). Risk factors for AKI included older age, male gender, diabetes and need ... Hospitalized COVID-19 patients with AKI associated with ARF have poor chances of survival. Diagnosing and ...

Abstract	Introduction: Acute respiratory failure (ARF) is the main clinical sign of coronavirus disease-2019 (COVID-19), but little is known about the outcome of acute kidney injury (AKI) associated with ARF. Study design: Retrospective cohort study on clinical features of adult patients hospitalized with COVID-19 between March 1st and April 30th, 2020 in the district of Piacenza (Italy). Results: Among 1894 hospitalized patients, 1701 affected by COVID-19 underwent at least two serum creatinine evaluations. According to KDIGO definitions, 233 of 1,701 patients (13.7%) developed AKI: 159, 34, and 40 had stage 1, 2 and 3 AKI, respectively. Patients with AKI were older (mean age 73.5 ± 14 years, range 24-95) than those without AKI (72 ± 14 years, range 20-102). In-hospital mortality was high in COVID patients (567/1701 patients, 33%), which almost doubled among AKI patients (132/233 patients, 57%), compared with those without AKI (p < 0.01). Risk factors for AKI included older age, male gender, diabetes and need for ventilation. Fourteen patients with stage 3 AKI underwent renal replacement therapy (RRT). Conclusions: Hospitalized COVID-19 patients with AKI associated with ARF have poor chances of survival. Diagnosing and preventing the progression of renal damage is fundamental in order to delay initiating RRT, especially when resources are limited.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/therapy ; Adult ; Aged ; Aged, 80 and over ; COVID-19 ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Pandemics ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Young Adult
Language	English
Publishing date	2021-06-19
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1093991-x
ISSN	1724-6059 ; 1120-3625 ; 1121-8428
ISSN (online)	1724-6059
ISSN	1120-3625 ; 1121-8428
DOI	10.1007/s40620-021-01087-x
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Article ; Online: Risk Factors for Acute Kidney Injury in Adult Patients With COVID-19

Xiaoyue Cai / Guiming Wu / Jie Zhang / Lichuan Yang

Frontiers in Medicine, Vol

A Systematic Review and Meta-Analysis

2021 Volume 8

Abstract: ... that AKI is a strong independent risk factor for mortality in patients with COVID-19 and is associated ... rapidly around the world. Studies found that the incidence of acute kidney injury (AKI) in COVID-19 ... about AKI in COVID-19 patients. This study aimed to analyse the risk factors for AKI in adult patients ...

Abstract	Background and Objective: Since December 2019, coronavirus disease 2019 (COVID-19) has spread rapidly around the world. Studies found that the incidence of acute kidney injury (AKI) in COVID-19 patients was more than double the incidence of AKI in non-COVID-19 patients. Some findings confirmed that AKI is a strong independent risk factor for mortality in patients with COVID-19 and is associated with a three-fold increase in the odds of in-hospital mortality. However, little information is available about AKI in COVID-19 patients. This study aimed to analyse the risk factors for AKI in adult patients with COVID-19.Methods: A systematic literature search was conducted in PubMed, EMBASE, Web of Science, the Cochrane Library, CNKI, VIP and WanFang Data from 1 December 2019 to 30 January 2021. We extracted data from eligible studies to compare the effects of age, sex, chronic diseases and potential risk factors for AKI on the prognosis of adult patients with COVID-19.Results: In total, 38 studies with 42,779 patients were included in this analysis. The meta-analysis showed that male sex (OR = 1.37), older age (MD = 5.63), smoking (OR = 1.23), obesity (OR = 1.12), hypertension (OR=1.85), diabetes (OR=1.71), pneumopathy (OR = 1.36), cardiovascular disease (OR = 1.98), cancer (OR = 1.26), chronic kidney disease (CKD) (OR = 4.56), mechanical ventilation (OR = 8.61) and the use of vasopressors (OR = 8.33) were significant risk factors for AKI (P < 0.05).Conclusions: AKI is a common and serious complication of COVID-19. Overall, male sex, age, smoking, obesity, hypertension, diabetes, pneumopathy, cardiovascular disease, cancer, CKD, mechanical ventilation and the use of vasopressors were independent risk factors for AKI in adult patients with COVID-19. Clinicians need to be aware of these risk factors to reduce the incidence of AKI.System Review Registration: PROSPERO, identifier [CRD42021282233].
Keywords	risk factor ; acute kidney injury ; COVID-19 ; systematic review ; meta-analysis ; Medicine (General) ; R5-920
Subject code	610 ; 616
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
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Article ; Online: Community- and Hospital-Acquired Acute Kidney Injury in COVID-19: Different Phenotypes and Dismal Prognosis.

Martínez-Rueda, Armando J / Álvarez, Rigoberto D / Méndez-Pérez, R Angélica / Fernández-Camargo, Dheni A / Gaytan-Arocha, Jorge E / Berman-Parks, Nathan / Flores-Camargo, Areli / Comunidad-Bonilla, Roque A / Mejia-Vilet, Juan M / Arvizu-Hernandez, Mauricio / Ramirez-Sandoval, Juan C / Correa-Rotter, Ricardo / Vega-Vega, Olynka

Blood purification

2021 Volume 50, Issue 6, Page(s) 931–941

Abstract: Introduction: Acute kidney injury (AKI) is common in coronavirus disease 2019 (COVID-19). It is ... IQR 0-2]), and presented to the emergency department with more severe disease. Mortality rates were ... 95% CI 1.01-2.36), Charlson Comorbidity Index (OR 1.16, 95% CI 1.02-1.32), and SOFA score (OR 2.19 ...

Abstract	Introduction: Acute kidney injury (AKI) is common in coronavirus disease 2019 (COVID-19). It is unknown if hospital-acquired AKI (HA-AKI) and community-acquired AKI (CA-AKI) convey a distinct prognosis. Methods: The study aim was to evaluate the incidence and risk factors associated with both CA-AKI and HA-AKI. Consecutive patients hospitalized at a reference center for COVID-19 were included in this prospective cohort study. Results: We registered 349 (30%) AKI episodes in 1,170 hospitalized patients, 224 (19%) corresponded to CA-AKI, and 125 (11%) to HA-AKI. Compared to patients with HA-AKI, subjects with CA-AKI were older (61 years [IQR 49-70] vs. 50 years [IQR 43-61]), had more comorbidities (hypertension [44 vs. 26%], CKD [10 vs. 3%]), higher Charlson Comorbidity Index (2 points [IQR 1-4] vs. 1 point [IQR 0-2]), and presented to the emergency department with more severe disease. Mortality rates were not different between CA-AKI and HA-AKI (119 [53%] vs. 63 [50%], p = 0.66). In multivariate analysis, CA-AKI was strongly associated to a history of CKD (OR 4.17, 95% CI 1.53-11.3), hypertension (OR 1.55, 95% CI 1.01-2.36), Charlson Comorbidity Index (OR 1.16, 95% CI 1.02-1.32), and SOFA score (OR 2.19, 95% CI 1.87-2.57). HA-AKI was associated with the requirement for mechanical ventilation (OR 68.2, 95% CI 37.1-126), elevated troponin I (OR 1.95, 95% CI 1.01-3.83), and glucose levels at admission (OR 1.05, 95% CI 1.02-1.08). Discussion/conclusions: CA-AKI and HA-AKI portend an adverse prognosis in CO-VID-19. Nevertheless, CA-AKI was associated with a higher comorbidity burden (including CKD and hypertension), while HA-AKI occurred in younger patients by the time severe multiorgan disease developed.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Adult ; Age Factors ; Aged ; COVID-19/complications ; COVID-19/diagnosis ; Female ; Hospitalization ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Risk Factors ; SARS-CoV-2/isolation & purification
Language	English
Publishing date	2021-03-19
Publishing country	Switzerland
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	605548-5
ISSN	1421-9735 ; 0253-5068
ISSN (online)	1421-9735
ISSN	0253-5068
DOI	10.1159/000513948
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Article ; Online: Acute Kidney Injury Is Associated With In-hospital Mortality in Older Patients With COVID-19.

Yan, Qi / Zuo, Peiyuan / Cheng, Ling / Li, Yuanyuan / Song, Kaixin / Chen, Yuting / Dai, Yue / Yang, Yi / Zhou, Lun / Yu, Weiwei / Li, Yongsheng / Xie, Min / Zhang, Cuntai / Gao, Hongyu

The journals of gerontology. Series A, Biological sciences and medical sciences

2020 Volume 76, Issue 3, Page(s) 456–462

Abstract: ... However, information on kidney damage in older patients with COVID-19 is limited. Acute kidney injury (AKI) is common ... mortality in older patients with COVID-19.: Methods: We conducted a retrospective, observational ... not an uncommon complication in older patients with COVID-19 but is associated with a high risk ...

Abstract	Background: The epidemic of COVID-19 presents a special threat to older adults. However, information on kidney damage in older patients with COVID-19 is limited. Acute kidney injury (AKI) is common in hospitalized adults and associated with poor prognosis. We sought to explore the association between AKI and mortality in older patients with COVID-19. Methods: We conducted a retrospective, observational cohort study in a large tertiary care university hospital in Wuhan, China. All consecutive inpatients older than 65 years with COVID-19 were enrolled in this cohort. Demographic data, laboratory values, comorbidities, treatments, and clinical outcomes were all collected. Data were compared between patients with AKI and without AKI. The association between AKI and mortality was analyzed. Results: Of 1764 in-hospital patients, 882 older adult cases were included in this cohort. The median age was 71 years (interquartile range: 68-77), 440 (49.9%) were men. The most presented comorbidity was cardiovascular diseases (58.2%), followed by diabetes (31.4%). Of 882 older patients, 115 (13%) developed AKI and 128 (14.5%) died. Patients with AKI had higher mortality than those without AKI (68 [59.1%] vs 60 [7.8%]; p < .001). Multivariable Cox regression analysis showed that increasing odds of in-hospital mortality are associated with higher interleukin-6 on admission, myocardial injury, and AKI. Conclusions: Acute kidney injury is not an uncommon complication in older patients with COVID-19 but is associated with a high risk of death. Physicians should be aware of the risk of AKI in older patients with COVID-19.
MeSH term(s)	Acute Kidney Injury/mortality ; Aged ; Aged, 80 and over ; COVID-19/epidemiology ; COVID-19/mortality ; China/epidemiology ; Female ; Hospital Mortality ; Hospitalization ; Humans ; Male ; Pandemics ; Pneumonia, Viral/mortality ; Pneumonia, Viral/virology ; Prognosis ; Retrospective Studies ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-08-27
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1223643-3
ISSN	1758-535X ; 1079-5006
ISSN (online)	1758-535X
ISSN	1079-5006
DOI	10.1093/gerona/glaa181
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Article: Acute cardiac injury is associated with adverse outcomes, including mortality in COVID-19 patients. A single-center experience.

Naeem, Kashif B / Hachim, Mahmood Y / Hachim, Ibrahim Y / Chkhis, Ayman / Quadros, Rajesh / Hannawi, Haifa / Al Salmi, Issa / Alokaily, Fahdah / Hannawi, Suad

Saudi medical journal

2020 Volume 41, Issue 11, Page(s) 1204–1210

Abstract: Objectives: To evaluate acute cardiac injury in COVID-19 patients and its association with adverse ... admissions; a higher rate of complications including acute kidney and liver injury, acidosis, septic shock ... risk of death.: Conclusion: Acute cardiac injury is common among Coronavirus disease-19 patients ...

Abstract	Objectives: To evaluate acute cardiac injury in COVID-19 patients and its association with adverse outcomes including mortality in the United Arab Emirates (UAE) population. Methods: A retrospective study conducted between February and June 2020 in Dubai, UAE, for all laboratory-confirmed Coronavirus disease-19 patients. Demographic, clinical, laboratory, radiological, and clinical outcomes were compared between patients with and without acute cardiac injury. Results: During the study period, 203 patients were included, of which, 44 (21.7%) had evidence of acute cardiac injury. Compared with patients without acute cardiac injury, patients with acute cardiac injury were: older, had more shortness of breath, diabetes, hypertension, and more bilateral airspace shadowing on admission chest radiography. These patients also had a higher neutrophil count, C-reactive protein, procalcitonin, ferritin, D-dimers and lactate dehydrogenase but lower lymphocyte count. Regarding outcomes, these patients had higher intensive care admissions; a higher rate of complications including acute kidney and liver injury, acidosis, septic shock, acute respiratory distress syndrome, needed more mechanical ventilation, and had a significantly higher risk of death. Conclusion: Acute cardiac injury is common among Coronavirus disease-19 patients. These patients present with higher comorbidities, have high inflammatory markers and have greater risk for in-hospital multi-organ damage, need for mechanical ventilation, and death. Prompt full assessment and intervention are recommended.
MeSH term(s)	Acute Disease ; Adult ; Aged ; COVID-19 ; Cause of Death ; Cohort Studies ; Comorbidity ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Female ; Heart Injuries/diagnosis ; Heart Injuries/epidemiology ; Hospital Mortality/trends ; Hospitalization/statistics & numerical data ; Hospitals, Urban ; Humans ; Male ; Middle Aged ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; Retrospective Studies ; Saudi Arabia/epidemiology ; Severity of Illness Index ; Survival Rate
Keywords	covid19
Language	English
Publishing date	2020-10-29
Publishing country	Saudi Arabia
Document type	Comparative Study ; Journal Article
ZDB-ID	392302-2
ISSN	1658-3175 ; 0379-5284
ISSN (online)	1658-3175
ISSN	0379-5284
DOI	10.15537/smj.2020.11.25466
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