Comparison of COVID-19 versus influenza on the incidence, features, and recovery from acute kidney injury in hospitalized United States Veterans

Birkelo, Bethany C.; Parr, Sharidan K.; Perkins, Amy M.; Greevy, Robert A.; Hung, Adriana M.; Shah, Shailja C.; Arroyo, Juan Pablo; Denton, Jason; Vincz, Andrew J.; Matheny, Michael E.; Siew, Edward D.

doi:10.1016/j.kint.2021.05.029

Cited by 26 publications

(40 citation statements)

References 41 publications

(43 reference statements)

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“…2 b) [ 31 ]. Additionally, rates of AKI and need for dialysis were much greater during the course of COVID-19 compared to influenza respiratory infections, as demonstrated by large scale comparison studies [ 32 , 33 ]. Many mechanisms of kidney involvement in the acute phase of COVID-19 have been proposed: systemic factors including hemodynamic instability in response to sepsis or multi-organ failure (most commonly found in the so-called pre-renal AKI), cytokine-mediated injury and direct viral invasion, as described in the previous section.…”

Section: Kidney Involvement In the Acute Phase Of Covid-19mentioning

confidence: 99%

Post-acute COVID-19 syndrome and kidney diseases: what do we know?

Çöpür

Berkkan

Basile³

et al. 2022

J Nephrol

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COVID-19, a disease caused by a novel coronavirus (SARS-CoV-2), is a major global threat that has turned into a pandemic. Despite the emergence of multiple vaccination alternatives and developing therapeutic options, dramatic short- and long-term clinical outcomes have been recorded with more than 250 million infected people and over 5 million deaths as of November 2021. COVID-19 presents various respiratory, cardiovascular, neuropsychiatric, musculoskeletal and kidney features during the acute phase; nevertheless, renal involvement in the post-infection period has recently been emphasized. The present review aims to evaluate the growing literature on kidney involvement in the SARS-CoV-2 infection along with clinical features reported both in the acute phase of the infection and in the post-acute COVID-19 period by assessing potential pathophysiological frameworks explaining such conditions. Chronic kidney disease and development of acute kidney injury (AKI) in the course of initial hospitalization are associated with high mortality and morbidity rates. Moreover, growing evidence suggests a decline in renal function in the 6-to-12-month follow-up period even in patients without any signs of AKI during the acute phase. Despite such concerns there are no guidelines regulating the follow-up period or therapeutic alternatives for such patient population. In conclusion, the burden of COVID-19 on the kidney is yet to be determined. Future prospective large scale studies are needed with long follow-up periods assessing kidney involvement via multiple parameters such as biopsy studies, urinalysis, measurement of serum creatinine and cystatin C, directly measured glomerular filtration rate, and assessment of tubular function via urinary β 2 -microglobulin measurements. Graphical abstract

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Section: Kidney Involvement In the Acute Phase Of Covid-19mentioning

confidence: 99%

Post-acute COVID-19 syndrome and kidney diseases: what do we know?

Çöpür

Berkkan

Basile³

et al. 2022

J Nephrol

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“…The incidence and the severity of AKI are affected by multiple comorbidity factors such as CKD, hypertension, diabetes, congestive heart failure, and age [ 23 ]. AKI occurred in nearly half of all patients hospitalized with COVID-19 and the majority of those admitted to the intensive care unit [ 22 , 24 ]. AKI is also associated with high mortality [ 25 ].…”

Section: Epidemiology and Clinical Presentationsmentioning

confidence: 99%

Similarities and Differences between COVID-19-Associated Nephropathy and HIV-Associated Nephropathy

et al. 2021

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Kidney disease is a major complication of viral infection, which can cause both acute and chronic kidney diseases via different mechanisms such as immune-mediated injury, kidney cell injury from a direct viral infection, systemic effects, and antiviral drug-induced nephrotoxicity. HIV-associated nephropathy (HIVAN), characterized by collapsing focal segmental glomerulosclerosis (cFSGS), has been described 2 decades ago as a major complication of acquired-immunodeficiency syndrome. The pathogenesis of HIVAN has been well studied, including viral entry, host response, and genetic factors. The incidence of this disease has been dramatically dropped with current antiretroviral therapy. In the recent severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic, acute kidney injury was also found to be a major complication in patients with (coronavirus disease) COVID-19. These patients also developed glomerular disease such as cFSGS in African Americans with apolipoprotein L1 risk alleles, similar to HIVAN. Whether SARS-CoV-2 can infect kidney cells locally remains controversial, but both local infection and systemic effects are likely involved in the pathogenesis of this disease. In this review, we present a comparison of the clinical presentations, pathological findings, disease mechanisms, and potential treatments between HIVAN and COVID-19. Leveraging the knowledge in HIVAN and experimental approaches used to study HIVAN will facilitate the exploration in the pathogenesis of COVID-19-associated kidney disease and improve our management of COVID-19 patients.

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“…Interestingly, an exception to this finding was constituted by patients affected by malignancies who, probably due to the severity of the underlying disease, continued to access the hospital also during the pandemic, as proved by the increased prevalence of these patients among SARS-CoV-2-negative patients admitted in the COVID-19 period. Finally, it is not possible to rule out that the different outcomes during the pandemic were also correlated with peculiar pathogenic mechanisms of AKI developing in SARS-CoV-2-infected patients [ 18 ]. Moreover, looking again at the kidney function, we found that sCr levels at discharge were significantly higher in patients hospitalized in the COVID-19 period compared to the pre-COVID-19 period.…”

Section: Discussionmentioning

confidence: 99%

Changes of Acute Kidney Injury Epidemiology during the COVID-19 Pandemic: A Retrospective Cohort Study

Esposito

Russo

Picciotto

et al. 2022

JCM

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To evaluate the impact of the Coronavirus Disease-19 (COVID-19) pandemic on the epidemiology of acute kidney injury (AKI) in hospitalized patients, we performed a retrospective cohort study comparing data of patients hospitalized from January 2016 to December 2019 (pre-COVID-19 period) and from January to December 2020 (COVID-19 period, including both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative and positive patients). AKI was classified by evaluating the kinetics of creatinine levels. A total of 51,681 patients during the pre-COVID-19 period and 10,062 during the COVID-19 period (9026 SARS-CoV-2-negative and 1036 SARS-CoV-2-positive) were analyzed. Patients admitted in the COVID-19 period were significantly older, with a higher prevalence of males. In-hospital AKI incidence was 31.7% during the COVID-19 period (30.5% in SARS-CoV-2-negative patients and 42.2% in SARS-CoV-2-positive ones) as compared to 25.9% during the pre-COVID-19 period (p < 0.0001). In the multivariate analysis, AKI development was independently associated with both SARS-CoV-2 infection and admission period. Moreover, evaluating the pre-admission estimated glomerular filtration rate (eGFR) we found that during the COVID-19 period, there was an increase in AKI stage 2–3 incidence both in patients with pre-admission eGFR < 60 mL/min/1.73 m2 and in those with eGFR ≥ 60 mL/min/1.73 m2 (“de novo” AKI). Similarly, clinical outcomes evaluated as intensive care unit admission, length of hospital stay, and mortality were significantly worse in patients admitted in the COVID-19 period. Additionally, in this case, the mortality was independently correlated with the admission during the COVID-19 period and SARS-CoV-2 infection. In conclusion, we found that during the COVID-19 pandemic, in-hospital AKI epidemiology has changed, not only for patients affected by COVID-19. These modifications underline the necessity to rethink AKI management during health emergencies.

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Comparison of COVID-19 versus influenza on the incidence, features, and recovery from acute kidney injury in hospitalized United States Veterans

Cited by 26 publications

References 41 publications

Post-acute COVID-19 syndrome and kidney diseases: what do we know?

Post-acute COVID-19 syndrome and kidney diseases: what do we know?

Similarities and Differences between COVID-19-Associated Nephropathy and HIV-Associated Nephropathy

Changes of Acute Kidney Injury Epidemiology during the COVID-19 Pandemic: A Retrospective Cohort Study

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