AKI in Hospitalized Patients with COVID-19 and Seasonal Influenza: A Comparative Analysis

Bhasin, Bhavna; Veitla, Vineet; Dawson, Aprill Z.; Garacci, Emma; Sturgill, Daniel; Ozieh, Mukoso N.; Regner, Kevin R.

doi:10.34067/kid.0007322020

Cited by 7 publications

(15 citation statements)

References 34 publications

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“…Bhasin et al found a similar incidence of AKI in both groups (33%) in agreement with our results. In their study, however, COVID-19 was an independent risk factor for severe AKI compared to influenza, which was not the case in our study, and this may be due to the fact that the COVID-19 cohort and Influenza cohort had significant population differences which were not a covariate in their model [60].…”

Section: Discussioncontrasting

confidence: 91%

Risk factors, clinical characteristics and prognostic value of acute kidney injury in COVID-19 compared with influenza virus and respiratory syncytial virus

et al. 2023

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Background Acute Kidney Injury (AKI) complicates a substantial part of patients with COVID-19. Direct viral penetration of renal cells through the Angiotensin Converting Enzyme 2 receptor, and indirect damage by the aberrant inflammatory response characteristic of COVID-19 are likely mechanisms. Nevertheless, other common respiratory viruses such as Influenza and Respiratory Syncytial Virus (RSV) are also associated with AKI. Methods We retrospectively compared the incidence, risk factors and outcomes of AKI among patients who were admitted to a tertiary hospital because of infection with COVID-19, influenza (A + B) or RSV. Results We collected data of 2593 patients hospitalized with COVID-19, 2041 patients with influenza and 429 with RSV. Patients affected by RSV were older, had more comorbidities and presented with higher rates of AKI at admission and within 7 days (11.7% vs. 13.3% vs. 18% for COVID-19, influenza and RSV, respectively p = 0.001). Nevertheless, patients hospitalized with COVID-19 had higher mortality (18% with COVID-19 vs. 8.6% and 13.5% for influenza and RSV, respectively P < 0.001) and higher need of mechanical ventilation (12.4% vs. 6.5% vs.8.2% for COVID-19, influenza and RSV, respectively, P = 0.002). High ferritin levels and low oxygen saturation were independent risk factors for severe AKI only in the COVID-19 group. AKI in the first 48 h of admission and in the first 7 days of hospitalization were strong independent risk factors for adverse outcome in all groups. Conclusion Despite many reports of direct kidney injury by SARS-COV-2, AKI was less in patients with COVID-19 compared to influenza and RSV patients. AKI was a prognostic marker for adverse outcome across all viruses. Graphical abstract Supplementary Information The online version contains supplementary material available at 10.1007/s40620-023-01591-2.

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Section: Discussioncontrasting

confidence: 91%

Risk factors, clinical characteristics and prognostic value of acute kidney injury in COVID-19 compared with influenza virus and respiratory syncytial virus

et al. 2023

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“…However, in a prospective pilot study of 30 mechanically ventilated patients (15 with COVID-19 and 15 with ARDS due to other causes), the COVID-19 patients had decreased renal blood flow despite similar ventilatory management [92]. Similarly, in an analysis of over 750 patients hospitalized with influenza or COVID-19, the risk of stage 3 AKI was higher in the COVID-19 cohort than the influenza group, and mechanical ventilation was associated with an increased risk of AKI in the COVID-19 group but not the influenza cohort [93].…”

Section: Indirect Contributors To Covid-19-associated Akimentioning

confidence: 92%

Kidney Injury in COVID-19: Epidemiology, Molecular Mechanisms and Potential Therapeutic Targets

Teixeira

Barone

Zahedi

et al. 2022

IJMS

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As of December 2021, SARS-CoV-2 had caused over 250 million infections and 5 million deaths worldwide. Furthermore, despite the development of highly effective vaccines, novel variants of SARS-CoV-2 continue to sustain the pandemic, and the search for effective therapies for COVID-19 remains as urgent as ever. Though the primary manifestation of COVID-19 is pneumonia, the disease can affect multiple organs, including the kidneys, with acute kidney injury (AKI) being among the most common extrapulmonary manifestations of severe COVID-19. In this article, we start by reflecting on the epidemiology of kidney disease in COVID-19, which overwhelmingly demonstrates that AKI is common in COVID-19 and is strongly associated with poor outcomes. We also present emerging data showing that COVID-19 may result in long-term renal impairment and delve into the ongoing debate about whether AKI in COVID-19 is mediated by direct viral injury. Next, we focus on the molecular pathogenesis of SARS-CoV-2 infection by both reviewing previously published data and presenting some novel data on the mechanisms of cellular viral entry. Finally, we relate these molecular mechanisms to a series of therapies currently under investigation and propose additional novel therapeutic targets for COVID-19.

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“…In either pathway, the inflammatory and immunological response is a crucial key player in the pathophysiological process [ 3 , 4 ]. AKI due to COVID-19 compared to other forms of AKI appears to manifest in a worse phenotype of AKI in terms of incidence, severity, and electrolyte derangements [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Outcomes Associated with Hyperuricemia in Hospitalized Patients with COVID-19

et al. 2021

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Introduction: Coronavirus 2019 (COVID-19) can increase catabolism and result in hyperuricemia. Uric acid (UA) potentially causes kidney damage by alteration of renal autoregulation, inhibition of endothelial cell proliferation, cell apoptosis, activation of the pro-inflammatory cascade, and crystal deposition. Hyperuricemia in patients with COVID-19 may contribute to acute kidney injury (AKI) and poor outcomes. Methods: We included 834 patients with COVID-19 who were >18 years old and hospitalized for >24 h in the Mount Sinai Health System and had at least 1 measurement of serum UA. We examined the association between the first serum UA level and development of acute kidney injury (AKI, defined by KDIGO criteria), major adverse kidney events (MAKE, defined by a composite of all-cause in-hospital mortality or dialysis or 100% increase in serum creatinine from baseline), as well as markers of inflammation and cardiac injury. Results: Among the 834 patients, the median age was 66 years, 42% were women, and the median first serum UA was 5.9 mg/dL (interquartile range 4.5–8.8). Overall, 60% experienced AKI, 52% experienced MAKE, and 32% died during hospitalization. After adjusting for demographics, comorbidities, and laboratory values, a doubling in serum UA was associated with increased AKI (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.9–4.1), MAKE (OR 2.5, 95% CI 1.7–3.5), and in-hospital mortality (OR 1.7, 95% CI 1.3–2.3). Higher serum UA levels were independently associated with a higher level of procalcitonin (β, 0.6; SE 0.2) and troponin I (β, 1.2; SE 0.2) but were not associated with serum ferritin, C-reactive protein, and interleukin-6. Conclusion: In patients admitted to the hospital for COVID-19, higher serum UA levels were independently associated with AKI, MAKE, and in-hospital mortality in a dose-dependent manner. In addition, hyperuricemia was associated with higher procalcitonin and troponin I levels.

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AKI in Hospitalized Patients with COVID-19 and Seasonal Influenza: A Comparative Analysis

Cited by 7 publications

References 34 publications

Risk factors, clinical characteristics and prognostic value of acute kidney injury in COVID-19 compared with influenza virus and respiratory syncytial virus

Risk factors, clinical characteristics and prognostic value of acute kidney injury in COVID-19 compared with influenza virus and respiratory syncytial virus

Kidney Injury in COVID-19: Epidemiology, Molecular Mechanisms and Potential Therapeutic Targets

Prevalence and Outcomes Associated with Hyperuricemia in Hospitalized Patients with COVID-19

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