Bhavna Bhasin1, Vineet Veitla1, Aprill Z Dawson2,3, Zhuping Garacci2,3, Daniel Sturgill4, Mukoso N Ozieh1,2, Kevin R Regner1. 1. Division of Nephrology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. 2. Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin. 3. Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. 4. Bellin Health Systems, Green Bay, Wisconsin.
Abstract
Background: Coronavirus disease 2019 (COVID-19) is often compared with seasonal influenza and the two diseases have similarities, including the risk of systemic manifestations such as AKI. The aim of this study was to perform a comparative analysis of the prevalence, risk factors, and outcomes of AKI in patients who were hospitalized with COVID-19 and influenza. Methods: Retrospective cohort study of patients who were hospitalized with COVID-19 (n=325) or seasonal influenza (n=433). AKI was defined by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Baseline characteristics and hospitalization data were collected, and multivariable analysis was performed to determine the independent predictors for AKI. Results: AKI occurred in 33% of COVID-19 hospitalizations (COV-AKI) and 33% of influenza hospitalizations (FLU-AKI). After adjusting for age, sex, and comorbidity count, the risk of stage 3 AKI was significantly higher in COV-AKI (OR, 3.46; 95% CI, 1.63 to 7.37). Pre-existing CKD was associated with a six- to seven-fold increased likelihood for FLU-AKI and COV-AKI. Mechanical ventilation was associated with a higher likelihood of developing AKI in the COVID-19 cohort (OR, 5.85; 95% CI, 2.30 to 15.63). Black race, after adjustment for comorbidities, was an independent risk for COV-AKI. Conclusions: Pre-existing CKD was a major risk factor for AKI in both cohorts. Black race (independent of comorbidities) and mechanical ventilation were associated with a higher risk of developing COV-AKI, which is characterized by a higher burden of stage 3 AKI and overall poorer prognosis.
Background: Coronavirus disease 2019 (COVID-19) is often compared with seasonal influenza and the two diseases have similarities, including the risk of systemic manifestations such as AKI. The aim of this study was to perform a comparative analysis of the prevalence, risk factors, and outcomes of AKI in patients who were hospitalized with COVID-19 and influenza. Methods: Retrospective cohort study of patients who were hospitalized with COVID-19 (n=325) or seasonal influenza (n=433). AKI was defined by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Baseline characteristics and hospitalization data were collected, and multivariable analysis was performed to determine the independent predictors for AKI. Results: AKI occurred in 33% of COVID-19 hospitalizations (COV-AKI) and 33% of influenza hospitalizations (FLU-AKI). After adjusting for age, sex, and comorbidity count, the risk of stage 3 AKI was significantly higher in COV-AKI (OR, 3.46; 95% CI, 1.63 to 7.37). Pre-existing CKD was associated with a six- to seven-fold increased likelihood for FLU-AKI and COV-AKI. Mechanical ventilation was associated with a higher likelihood of developing AKI in the COVID-19 cohort (OR, 5.85; 95% CI, 2.30 to 15.63). Black race, after adjustment for comorbidities, was an independent risk for COV-AKI. Conclusions: Pre-existing CKD was a major risk factor for AKI in both cohorts. Black race (independent of comorbidities) and mechanical ventilation were associated with a higher risk of developing COV-AKI, which is characterized by a higher burden of stage 3 AKI and overall poorer prognosis.
Authors: Fabio Carmona; Ana P C P Carlotti; Leandra N Z Ramalho; Roberto S Costa; Fernando S Ramalho Journal: Am J Clin Pathol Date: 2011-09 Impact factor: 2.493
Authors: Aakriti Gupta; Mahesh V Madhavan; Kartik Sehgal; Nandini Nair; Shiwani Mahajan; Tejasav S Sehrawat; Behnood Bikdeli; Neha Ahluwalia; John C Ausiello; Elaine Y Wan; Daniel E Freedberg; Ajay J Kirtane; Sahil A Parikh; Mathew S Maurer; Anna S Nordvig; Domenico Accili; Joan M Bathon; Sumit Mohan; Kenneth A Bauer; Martin B Leon; Harlan M Krumholz; Nir Uriel; Mandeep R Mehra; Mitchell S V Elkind; Gregg W Stone; Allan Schwartz; David D Ho; John P Bilezikian; Donald W Landry Journal: Nat Med Date: 2020-07-10 Impact factor: 53.440
Authors: Mitra K Nadim; Lui G Forni; Ravindra L Mehta; Michael J Connor; Kathleen D Liu; Marlies Ostermann; Thomas Rimmelé; Alexander Zarbock; Samira Bell; Azra Bihorac; Vincenzo Cantaluppi; Eric Hoste; Faeq Husain-Syed; Michael J Germain; Stuart L Goldstein; Shruti Gupta; Michael Joannidis; Kianoush Kashani; Jay L Koyner; Matthieu Legrand; Nuttha Lumlertgul; Sumit Mohan; Neesh Pannu; Zhiyong Peng; Xose L Perez-Fernandez; Peter Pickkers; John Prowle; Thiago Reis; Nattachai Srisawat; Ashita Tolwani; Anitha Vijayan; Gianluca Villa; Li Yang; Claudio Ronco; John A Kellum Journal: Nat Rev Nephrol Date: 2020-10-15 Impact factor: 28.314
Authors: Jamie S Hirsch; Jia H Ng; Daniel W Ross; Purva Sharma; Hitesh H Shah; Richard L Barnett; Azzour D Hazzan; Steven Fishbane; Kenar D Jhaveri Journal: Kidney Int Date: 2020-05-16 Impact factor: 10.612