Match!

ACUTE KIDNEY INJURY IN PATIENTS HOSPITALIZED WITH COVID-19

Published on May 13, 2020in Kidney International8.306
· DOI :10.1016/J.KINT.2020.05.006
Jamie S. Hirsch (Hofstra University), Jia H. Ng (Hofstra University)+ 6 AuthorsKenar D. Jhaveri17
Estimated H-index: 17
(Hofstra University)
Abstract
Abstract The rate of acute kidney injury (AKI) associated with patients hospitalized with Covid-19, and associated outcomes are not well understood. This study describes the presentation, risk factors and outcomes of AKI in patients hospitalized with Covid-19. We reviewed the health records for all patients hospitalized with Covid-19 between March 1, and April 5, 2020, at 13 academic and community hospitals in metropolitan New York. Patients younger than 18 years of age, with end stage kidney disease or with a kidney transplant were excluded. AKI was defined according to KDIGO criteria. Of 5,449 patients admitted with Covid-19, AKI developed in 1,993 (36.6%). The peak stages of AKI were stage 1 in 46.5%, stage 2 in 22.4% and stage 3 in 31.1%. Of these, 14.3% required renal replacement therapy (RRT). AKI was primarily seen in Covid-19 patients with respiratory failure, with 89.7% of patients on mechanical ventilation developing AKI compared to 21.7% of non-ventilated patients. 276/285 (96.8%) of patients requiring RRT were on ventilators. Of patients who required ventilation and developed AKI, 52.2% had the onset of AKI within 24 hours of intubation. Risk factors for AKI included older age, diabetes mellitus, cardiovascular disease, black race, hypertension and need for ventilation and vasopressor medications. Among patients with AKI, 694 died (35%), 519 (26%) were discharged and 780 (39%) were still hospitalized. AKI occurs frequently among patients with Covid-19 disease. It occurs early and in temporal association with respiratory failure and is associated with a poor prognosis.
  • References (27)
  • Citations (4)
References27
Newest
Intravenous infusions of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in experimental animals increase the numbers of angiotensin-converting enzyme 2 (ACE2) receptors in the cardiopulmonary circulation. ACE2 receptors serve as binding sites for SARS-CoV-2 virions in the lungs. Patients who take ACEIs and ARBS may be at increased risk of severe disease outcomes due to SARS-CoV-2 infections.
46 CitationsSource
#2Ran LuoH-Index: 2
Last. Gang XuH-Index: 23
view all 10 authors...
Abstract In December 2019, a coronavirus 2019 (COVID-19) disease outbreak occurred in Wuhan, Hubei Province, China, and rapidly spread to other areas worldwide. Although diffuse alveolar damage and acute respiratory failure were the main features, the involvement of other organs needs to be explored. Since information on kidney disease in patients with COVID-19 is limited, we determined the prevalence of acute kidney injury (AKI) in patients with COVID-19. Further, we evaluated the association b...
122 CitationsSource
37 CitationsSource
#1Safiya Richardson (Hofstra University)H-Index: 4
#2Jamie S. Hirsch (Hofstra University)
Last. Stuart L. Cohen (Hofstra University)
view all 27 authors...
Importance: There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19). Objective: To describe the clinical characteristics and outcomes of patients with COVID-19 hospitalized in a US health care system. Design, Setting, and Participants: Case series of patients with COVID-19 admitted to 12 hospitals in New York City, Long Island, and Westchester County, New York, within the Northwell Health...
274 CitationsSource
What is already known about this topic? Community transmission of COVID-19 was first detected in the United States in February 2020. By mid-March, all 50 states, the District of Columbia, New York City, and four U.S. territories had reported cases of COVID-19. What is added by this report? As of April 7, cumulative incidence of COVID-19 ranged widely across U.S. jurisdictions (from 20.6 to 915.3 cases per 100,000) and 7-day increases in incidence varied considerably (from 8.3 to 418.0). This rep...
17 CitationsSource
#1Jixiang Zhang (WHU: Wuhan University)H-Index: 11
#2Xiaoli Wang (WHU: Wuhan University)H-Index: 1
Last. Hongang Yu (WHU: Wuhan University)H-Index: 1
view all 17 authors...
Abstract Objective Since December 2019, coronavirus disease (COVID-19) emerged in Wuhan. However, the characteristics and risk factors associated with disease severity, unimprovement and mortality are unclear. Methods All consecutive patients diagnosed with COVID-19 admitted to the Renmin Hospital of Wuhan University from January 11 to February 6, 2020 were enrolled in this retrospective cohort study. Results A total of 663 COVID-19 patients were included in this study. Among those, 247 (37.3%) ...
13 CitationsSource
#1Ruchong ChenH-Index: 6
#2Wenhua LiangH-Index: 18
Last. Zheng-yi NiH-Index: 4
view all 37 authors...
BACKGROUND The novel coronavirus disease 2019 (COVID-19) has become a global health emergency. Cumulative number of new confirmed case and death are still increasing out of China. However, the independent predicted factors associated with the fatal outcome remain uncertain. METHODS A retrospective cohort of 1590 hospitalized subjects with COVID-19 throughout China was established. The prognostic effects of variables, including clinical features and laboratory findings, were analyzed using Kapla-...
23 CitationsSource
#1Arthur SimonnetH-Index: 1
#2Mikael Chetboun (Pasteur Institute)H-Index: 1
Last. Merce Jourdain (Pasteur Institute)H-Index: 1
view all 10 authors...
OBJECTIVE: The Covid-19 pandemic is rapidly spreading worldwide, notably in Europe and North America, where obesity is highly prevalent. The relation between obesity and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has not been fully documented. METHODS: In this retrospective cohort study we analyzed the relationship between clinical characteristics, including body mass index (BMI), and the requirement for invasive mechanical ventilation (IMV) in 124 consecutive patients admitted...
95 CitationsSource
#1Hua Su (HUST: Huazhong University of Science and Technology)H-Index: 8
#2Ming Yang (HUST: Huazhong University of Science and Technology)H-Index: 1
Last. Xiu Nie (HUST: Huazhong University of Science and Technology)H-Index: 1
view all 11 authors...
Abstract Although the respiratory and immune systems are the major targets of Coronavirus Disease 2019 (COVID-19), acute kidney injury and proteinuria have also been observed. Currently, detailed pathologic examination of kidney damage in critically ill patients with COVID-19 has been lacking. To help define this we analyzed kidney abnormalities in 26 autopsies of patients with COVID-19 by light microscopy, ultrastructural observation and immunostaining. Patients were on average 69 years (19 mal...
57 CitationsSource
#1Lei FangH-Index: 1
#2George KarakiulakisH-Index: 22
Last. Michael RothH-Index: 53
view all 3 authors...
The most distinctive comorbidities of 32 non-survivors from a group of 52 intensive care unit patients with novel coronavirus disease 2019 (COVID-19) in the study by Xiaobo Yang and colleagues1 were cerebrovascular diseases (22%) and diabetes (22%). Another study2 included 1099 patients with confirmed COVID-19, of whom 173 had severe disease with comorbidities of hypertension (23·7%), diabetes mellitus (16·2%), coronary heart diseases (5·8%), and cerebrovascular disease (2·3%). In a third study,...
343 CitationsSource
Cited By4
Newest
#1Sinan Trabulus (Istanbul University)H-Index: 7
#2Cebrail Karaca (Istanbul University)
Last. Mert Ahmet Kuskucu (Istanbul University)H-Index: 6
view all 13 authors...
Background Recent data have reinforced the concept of a reciprocal relationship between COVID-19 and kidney function. However, most studies have focused on the effect of COVID-19 on kidney function, whereas data regarding kidney function on the COVID-19 prognosis is scarce. Therefore, in this study, we aimed to investigate the association between eGFR on admission and the mortality rate of COVID-19. Methods We recruited 336 adult consecutive patients (male 57.1%, mean age 55.0 ±15.9) that were h...
Source
Source
#1Horng-Ruey Chua (NUS: National University of Singapore)H-Index: 5
#2Graeme Mac Laren (NUS: National University of Singapore)H-Index: 1
Last. Boon Wee Teo (NUS: National University of Singapore)H-Index: 14
view all 20 authors...
Abstract With the exponential surge in coronavirus disease 2019 (COVID-19) patients worldwide, the resources needed to provide continuous kidney replacement therapy (CKRT) for patients with acute kidney injury or kidney failure may be threatened. This article summarizes subsisting strategies that can be implemented immediately. Pre-emptive weekly multi-center projections of CKRT demand based on evolving COVID-19 epidemiology and routine workload should be made. Corresponding consumables should b...
1 CitationsSource
#1Jeong-Hoon Lim (KNU: Kyungpook National University)H-Index: 5
#2Sun-Hee Park (KNU: Kyungpook National University)H-Index: 35
Last. Jaehee Lee (KNU: Kyungpook National University)H-Index: 12
view all 14 authors...
The outcome of coronavirus disease 2019 (COVID-19) is associated with organ damage; however, the information about the relationship between acute kidney injury (AKI) and COVID-19 is still rare. We evaluated the clinical features and prognosis of COVID-19 patients with AKI according to the AKI severity. Medical data of hospitalized COVID-19 patients in two university-based hospitals during an outbreak in Daegu, South Korea, were retrospectively analyzed. AKI and its severity were defined accordin...
1 CitationsSource