Jeremy Yuen-Chun Teoh1, Terry Cheuk-Fung Yip2,3, Grace Chung-Yan Lui2,3,4, Vincent Wai-Sun Wong5,3, Viola Chi-Ying Chow6, Tracy Hang-Yee Ho5, Timothy Chun-Man Li2, Yee-Kit Tse2,3, Peter Ka-Fung Chiu1, Chi-Fai Ng7, David Shu-Cheong Hui2,3,4, Henry Lik-Yuen Chan2,3, Cheuk-Chun Szeto8, Grace Lai-Hung Wong5,3. 1. Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China. 2. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China. 3. Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong, China. 4. Stanley Ho Centre for Emerging Infectious Diseases, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China. 5. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China wonglaihung@cuhk.edu.hk ccszeto@cuhk.edu.hk. 6. Department of Microbiology, The Chinese University of Hong Kong, Hong Kong, China. 7. Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China wonglaihung@cuhk.edu.hk ccszeto@cuhk.edu.hk. 8. Department of Medicine and Therapeutics, Carol and Richard Yu Peritoneal Dialysis Research Centre, The Chinese University of Hong Kong, Hong Kong, China wonglaihung@cuhk.edu.hk ccszeto@cuhk.edu.hk.
Abstract
BACKGROUND: Severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) are closely related. The effect of AKI on the clinical outcomes of these two conditions is unclear. METHODS: This retrospective, territory-wide cohort study used an electronic public healthcare database in Hong Kong to identify patients with SARS or COVID-19 by diagnosis codes, virologic results, or both. The primary endpoint was a composite of intensive care unit admission, use of invasive mechanical ventilation, and/or death. RESULTS: We identified 1670 patients with SARS and 1040 patients with COVID-19 (median ages, 41 versus 35 years, respectively). Among patients with SARS, 26% met the primary endpoint versus 5.3% of those with COVID-19. Diabetes mellitus, abnormal liver function, and AKI were factors significantly associated with the primary endpoint among patients with either SARS or COVID-19. Among patients with SARS, 7.9%, 2.1%, and 3.7% developed stage 1, stage 2, and stage 3 AKI, respectively; among those with COVID-19, 6.6%, 0.4%, and 1.1% developed stage 1, stage 2, and stage 3 AKI, respectively. In both groups, factors significantly associated with AKI included diabetes mellitus and hypertension. Among patients with AKI, those with COVID-19 had a lower rate of major adverse clinical outcomes versus patients with SARS. Renal function recovery usually occurred within 30 days after an initial AKI event. CONCLUSIONS: AKI rates were higher among patients with SARS than those with COVID-19. AKI was associated with major adverse clinical outcomes for both diseases. Patients with diabetes mellitus and abnormal liver function were also at risk of developing severe consequences after SARS and COVID-19 infection.
BACKGROUND: Severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) are closely related. The effect of AKI on the clinical outcomes of these two conditions is unclear. METHODS: This retrospective, territory-wide cohort study used an electronic public healthcare database in Hong Kong to identify patients with SARS or COVID-19 by diagnosis codes, virologic results, or both. The primary endpoint was a composite of intensive care unit admission, use of invasive mechanical ventilation, and/or death. RESULTS: We identified 1670 patients with SARS and 1040 patients with COVID-19 (median ages, 41 versus 35 years, respectively). Among patients with SARS, 26% met the primary endpoint versus 5.3% of those with COVID-19. Diabetes mellitus, abnormal liver function, and AKI were factors significantly associated with the primary endpoint among patients with either SARS or COVID-19. Among patients with SARS, 7.9%, 2.1%, and 3.7% developed stage 1, stage 2, and stage 3 AKI, respectively; among those with COVID-19, 6.6%, 0.4%, and 1.1% developed stage 1, stage 2, and stage 3 AKI, respectively. In both groups, factors significantly associated with AKI included diabetes mellitus and hypertension. Among patients with AKI, those with COVID-19 had a lower rate of major adverse clinical outcomes versus patients with SARS. Renal function recovery usually occurred within 30 days after an initial AKI event. CONCLUSIONS: AKI rates were higher among patients with SARS than those with COVID-19. AKI was associated with major adverse clinical outcomes for both diseases. Patients with diabetes mellitus and abnormal liver function were also at risk of developing severe consequences after SARS and COVID-19 infection.
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Authors: Grace Lai-Hung Wong; Terry Cheuk-Fung Yip; Vincent Wai-Sun Wong; Yee-Kit Tse; David Shu-Cheong Hui; Shui-Shan Lee; Eng-Kiong Yeoh; Henry Lik-Yuen Chan; Grace Chung-Yan Lui Journal: Open Forum Infect Dis Date: 2021-04-23 Impact factor: 3.835