Risks of AKI and Major Adverse Clinical Outcomes in Patients with Severe Acute Respiratory Syndrome or Coronavirus Disease 2019

Abstract

BackgroundSevere 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.MethodsThis 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.ResultsWe 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.ConclusionsAKI 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.

Incidence of Viral Rebound After Treatment With Nirmatrelvir-Ritonavir and Molnupiravir

“…A territory-wide, retrospective cohort study was performed using the Clinical Data Analysis and Reporting System (CDARS) managed by Hospital Authority, Hong Kong, with which multiple studies on COVID-19 have previously been conducted. 3 , 4 , 5 , 6 We first identified 41 255 patients with COVID-19 who were hospitalized from January 1, 2022, to March 31, 2022. Of these patients, 12 629 who attended public hospitals with serial cycle threshold (Ct) values measured at least 3 times were included in the analysis (eFigure 1 in Supplement 1 ).…”

COVID-19 Survival and its impact on chronic kidney disease

“…After the exclusions shown in Figure 2, we identified 24 unique cohort studies with ≥ 50 cases of hospitalized patients with COVID-19-related AKI that reported AKI recovery rates (Table 1). 12,14,16,17,20,[55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73] Although -full recovery‖ is variably defined in these studies, the proportion of surviving patients that experience a full recovery by hospital discharge ranges between 19-79%, with the majority of studies reporting that that >50% of survivors experience -kidney recovery‖ by hospital discharge. 16,20,56 Among those with AKI severe enough to require RRT, most survivors can discontinue RRT prior to hospital discharge, with continued dependence on RRT at hospital discharge ranging from 8-34% of surviving patients (Table 1).…”

Questionnaire Survey on the Current Situation and Experience in Prevention and Control Measures at Urology Clinics During the COVID-19 Epidemic in China

“…It was still unclear whether SARS-CoV-2 directly affect the kidney, although renal histopathological analyses of 26 Chinese COVID-19 patients suggested varying degrees of acute tubular injury ( 24 ). The prognosis of COVID-19 patients with acute kidney injury was poor, especially those patients with other underlying diseases ( 25 , 26 ).…”