Acute Kidney Injury Incidence, Recovery, and Long-term Kidney Outcomes Among Hospitalized Patients With COVID-19 and Influenza

Strohbehn, Ian A.; Zhao, Sophia; Seethapathy, Harish; Lee, Meghan; Rusibamayila, Nifasha; Allegretti, Andrew S.; Parada, Xavier Vela; Sise, Meghan E.

doi:10.1016/j.ekir.2021.07.008

Cited by 29 publications

(30 citation statements)

References 49 publications

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“…The study demonstrated results comparable with ours, showing an association with specific comorbidities such as obesity and diabetes. 10 Furthermore, the histology assessment of the kidneys of H1N1-infected patients also demonstrated acute tubular necrosis (ATN), DIC, and myoglobin pigments, 11 showing that tubular necrosis may be the common mechanism of renal injury of patients infected with these respiratory illnesses.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Incidence, Stage, and Recovery in Patients with COVID-19

Bandelac¹,

Shah²,

Purmessur³

et al. 2022

IJNRD

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Purpose To determine the incidence, mortality, stage, and recovery of acute kidney injury (AKI) in COVID-19 patients and further analyze the effect of patient demographics and comorbidities on AKI incidence. Study Design Our study looked at 1545 charts of patients over 18 years old who presented to BronxCare Hospital in NY with a positive SARS-CoV-2 PCR test. Using the KDIGO criteria, any patient presenting with a creatinine of 1.5 times the baseline or that had an increase in creatinine of 0.3mg/dL in 48 hours was diagnosed with AKI. Pregnant patients, patients with end-stage renal disease (ESRD), and patients with a history of renal transplant were excluded. Results The incidence of AKI in COVID-19 patients was 39% (608), and the mortality rate was 58.2% (354). Of the 254 survivors, 74.8% recovered. Moreover, 42.6% (259) of patients with AKI were admitted to the ICU. Twenty-six of our patients received hemodialysis during admission. There was a statistically significant association between AKI and age, race, hypertension (HTN), diabetes mellitus (DM), hepatitis C (HCV), congestive heart failure (CHF), CKD, patient outcome, and days spent in the hospital. Of the 608 patients with AKI, 294 (48.4%), 185 (30.4%) and 129 (21.2%) had AKI stage 1, 2 and 3, respectively. Conclusion Early resource planning is necessary when admitting COVID-19 patients. Nephrology should be consulted early, and measures should be in place to optimize outpatient follow-up in the nephrology clinic. Lastly, the use of nephrotoxic agents should be carefully considered and, if possible, avoided from the time of admission in patients with COVID-19.

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Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Incidence, Stage, and Recovery in Patients with COVID-19

Bandelac¹,

Shah²,

Purmessur³

et al. 2022

IJNRD

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“…In the study of Ng et al with CKD and non-CKD patients, 6.6% of the patients hospitalized due to COVID-19 developed AKI requiring dialysis, 17% of these patients survived, and 33.3% of the survivors, the kidneys did not improve at discharge [ 16 ]. In a study comparing COVID-19 with influenza, mortality and frequency of AKI were found to be higher in those with COVID-19, and 11% of patients with COVID-19 had a ≥ 25% GFR reduction from baseline at ≥ 90 days of follow-up [ 17 ]. In another study where patients who developed AKI due to COVID-19 were compared with patients who developed AKI due to another reason and upon follow-up after discharge, a greater decrease was observed in GFR of the COVID-19 patients [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Post-COVID-19 outcomes of non-dialysis dependent chronic kidney disease patients: a national, multicenter, controlled study

et al. 2022

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Purpose Coronavirus disease 2019 (COVID-19) has a higher mortality in the presence of chronic kidney disease (CKD). However, there has not been much research in the literature concerning the outcomes of CKD patients in the post-COVID-19 period. We aimed to investigate the outcomes of CKD patients not receiving renal replacement therapy. Methods In this multicenter observational study, we included CKD patients with a GFR < 60 ml/min/1.73 m 2 who survived after confirmed COVID-19. Patients with CKD whose kidney disease was due to diabetic nephropathy, polycystic kidney disease and glomerulonephritis were not included in this study. CKD patients with similar characteristics, who did not have COVID-19 were included as the control group. Results There were 173 patients in the COVID-19 group and 207 patients in the control group. Most patients (72.8%) were treated as inpatient in the COVID-19 group (intensive care unit hospitalization: 16.7%, acute kidney injury: 54.8%, needing dialysis: 7.9%). While there was no significant difference between the baseline creatinine values of the COVID-19 group and the control group (1.86 and 1.9, p = 0.978, respectively), on the 1st month, creatinine values were significantly higher in the COVID-19 group (2.09 and 1.8, respectively, p = 0.028). Respiratory system symptoms were more common in COVID-19 patients compared to the control group in the 1st month and 3rd month follow-ups ( p < 0.001). Mortality at 3 months after the diagnosis of COVID-19 was significantly higher in the COVID-19 group than in the control group (respectively; 5.2% and 1.4%, p :0.037). Similarly, the rate of patients requiring dialysis for COVID-19 was significantly higher than the control group (respectively; 8.1% and 3.4%, p : 0.045). Conclusions In CKD patients, COVID-19 was associated with increased mortality, as well as more deterioration in kidney function and higher need for dialysis in the post-COVID-19 period. These patients also had higher rate of ongoing respiratory symptoms after COVID-19.

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“…Hypertension and cardiovascular diseases have generally been correlated with COVID-19, whereas they have been reported as the most common comorbidities along with diabetes mellitus [ 32 ]. Severe acute kidney injury and liver manifestations, even if they are not currently clearly elucidated, have long been reported [ 33 , 34 ].…”

Section: The Principles Of Diagnosing Covid-19mentioning

confidence: 99%

COVID-19 Smart Diagnosis in the Emergency Department: all-in in Practice

Mouliou

Pantazopoulos

Gourgoulianis

2022

Expert Review of Respiratory Medicine

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Introduction Coronavirus Disease 19 (COVID-19) diagnosis has been a major problem in most Emergency Departments (EDs) and other senior care facilities. Various clinical manifestations, and the several radiologic and laboratory data combined with the misleading test results to identify the virus, are responsible for certain misdiagnoses, especially in suspected cases needing urgent management and treatment. Although emergency and other front-line physicians struggle to manage COVID-19 patients, still existent cases with ambiguous diagnosis trammel the ED safety and responsibility. Areas Covered This review article summarizes on a large scale the common information for the medical history, clinical examinations, radiology and laboratory data for SARS-CoV-2. We summarize the available literature using the PubMed, Science Direct and EMBASE databases published until December 2021 on the general information for COVID-19 diagnosis, and, finally, we propose algorithms for a precise and on-the-spot diagnosis the disease. Expert Opinion COVID-19 diagnosis has appeared to be such ambiguous, and physicians need to correlate medical history, medical examination, potential extrapulmonary manifestations, along with laboratory and radiologic data, for a prompt COVID-19 diagnosis.

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Acute Kidney Injury Incidence, Recovery, and Long-term Kidney Outcomes Among Hospitalized Patients With COVID-19 and Influenza

Cited by 29 publications

References 49 publications

Acute Kidney Injury Incidence, Stage, and Recovery in Patients with COVID-19

Acute Kidney Injury Incidence, Stage, and Recovery in Patients with COVID-19

Post-COVID-19 outcomes of non-dialysis dependent chronic kidney disease patients: a national, multicenter, controlled study

COVID-19 Smart Diagnosis in the Emergency Department: all-in in Practice

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