Jingyuan Xu1, Jianfeng Xie1, Bin Du2, Zhaohui Tong3, Haibo Qiu1, Sean M Bagshaw4. 1. Department of Critical Care Medicine, Zhongda Hospital, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Medicine, 12579Southeast University, Nanjing, China. 2. Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China. 3. Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, 74639Beijing Chao-yang Hospital, Capital Medical University, Beijing, China. 4. Department of Critical Care Medicine, Faculty of Medicine and Dentistry, 3158University of Alberta, Edmonton, Alberta, Canada.
Abstract
BACKGROUND: The incidence and outcome of Coronavirus disease 2019 (COVID-19)-induced kidney injury have been variably described. We aimed to describe the clinical characteristics, correlates and outcomes of critically ill patients with severe COVID-19 complicated by acute kidney injury (AKI). METHODS: We performed a multicenter retrospective cohort study of 671 critically ill adults with laboratory-confirmed COVID-19 from 19 hospitals in China between January 1 to February 29, 2020. Data were captured on demographics, comorbidities, symptoms, acute physiology, laboratory parameters, interventions, and outcomes. The primary exposure was ICU admission for confirmed COVID-19 related critically illness. The primary outcome was 28-day mortality. Secondary outcomes included factors associated with AKI, organ dysfunction, treatment intensity, and health services use. MEASUREMENTS AND MAIN RESULTS: Of 671 severe COVID-19 patients (median [IQR] 65 [56-73] years; male sex 65% (n = 434); hypertension 43% (n = 287) and APACHE II score 10 [7-14]), 39% developed AKI. Patients with AKI were older, had greater markers of inflammation and coagulation activation, and had greater acuity and organ dysfunction as presentation. Despite similar treatment with antivirals, patients with AKI had lower viral conversion negative rates than those without AKI. The 28-day mortality was much higher in AKI patients than patients without AKI (72% vs. 42%), and there was an increase in 28-day mortality according to the severity of AKI. Non-survivors were less likely to receive antiviral therapy [132 (70%) vs. 65 (88%)] compared with survivors and have lower viral negative conversion rate [17 (9%) vs. 47 (64%)]. CONCLUSIONS: Acute kidney injury was quite common in severe COVID-19 pneumonia, which associated with higher mortality.
BACKGROUND: The incidence and outcome of Coronavirus disease 2019 (COVID-19)-induced kidney injury have been variably described. We aimed to describe the clinical characteristics, correlates and outcomes of critically ill patients with severe COVID-19 complicated by acute kidney injury (AKI). METHODS: We performed a multicenter retrospective cohort study of 671 critically ill adults with laboratory-confirmed COVID-19 from 19 hospitals in China between January 1 to February 29, 2020. Data were captured on demographics, comorbidities, symptoms, acute physiology, laboratory parameters, interventions, and outcomes. The primary exposure was ICU admission for confirmed COVID-19 related critically illness. The primary outcome was 28-day mortality. Secondary outcomes included factors associated with AKI, organ dysfunction, treatment intensity, and health services use. MEASUREMENTS AND MAIN RESULTS: Of 671 severe COVID-19 patients (median [IQR] 65 [56-73] years; male sex 65% (n = 434); hypertension 43% (n = 287) and APACHE II score 10 [7-14]), 39% developed AKI. Patients with AKI were older, had greater markers of inflammation and coagulation activation, and had greater acuity and organ dysfunction as presentation. Despite similar treatment with antivirals, patients with AKI had lower viral conversion negative rates than those without AKI. The 28-day mortality was much higher in AKI patients than patients without AKI (72% vs. 42%), and there was an increase in 28-day mortality according to the severity of AKI. Non-survivors were less likely to receive antiviral therapy [132 (70%) vs. 65 (88%)] compared with survivors and have lower viral negative conversion rate [17 (9%) vs. 47 (64%)]. CONCLUSIONS: Acute kidney injury was quite common in severe COVID-19 pneumonia, which associated with higher mortality.
Authors: A Cau; M P Cheng; Terry Lee; A Levin; T C Lee; D C Vinh; F Lamontagne; J Singer; K R Walley; S Murthy; D Patrick; O Rewa; B Winston; J Marshall; J Boyd; J A Russell Journal: Can J Kidney Health Dis Date: 2021-10-30
Authors: Greet De Vlieger; Eric Hoste; Hannah Schaubroeck; Wim Vandenberghe; Willem Boer; Eva Boonen; Bram Dewulf; Camille Bourgeois; Jasperina Dubois; Alexander Dumoulin; Tom Fivez; Jan Gunst; Greet Hermans; Piet Lormans; Philippe Meersseman; Dieter Mesotten; Björn Stessel; Marc Vanhoof Journal: Crit Care Date: 2022-07-25 Impact factor: 19.334