Abstract
BackgroundThe clinical correlates, prognosis and determinants of acute kidney injury (AKI) in patients with coronavirus disease 2019 (Covid-19) remain largely unclear.MethodsWe retrospectively reviewed medical records of all adult patients with laboratory-confirmed Covid-19 who were admitted to the intensive care unit (ICU) between January 23rd 2020 and April 6th 2020 at Wuhan JinYinTan Hospital and The First Affiliated Hospital of Guangzhou Medical University.ResultsAmong 210 patients, 131 were males (62.4%). The median Age was 64 years (IQR: 56–71). Of 92 (43.8%) patients who developed AKI during hospitalization, 13 (14.1%), 15 (16.3%) and 64 (69.6%) were classified as being at stage 1, 2 and 3, respectively. 54 patients (58.7%) received continuous renal replacement therapy. Age, sepsis, nephrotoxic drug, invasive mechanical ventilation and elevated baseline serum creatinine levels were associated with the occurrence of AKI. Renal recovery during hospitalization was identified among 16 patients with AKI (17.4%), who had a significantly shorter time from admission to AKI diagnosis, lower incidence of right heart failure and higher ratio of partial pressure of oxygen to the fraction of inspired oxygen. Of 210 patients, 93 deceased within 28 days of ICU admission. AKI stage 3, critical disease, greater Age and the lowest ratio of partial pressure of oxygen to the fraction of inspired oxygen being < 150 mmHg were independently associated with death.ConclusionsAmong patients with Covid-19, the incidence of AKI was high. Our findings of the risk factors of the development of AKI and factors associated with renal function recovery may inform clinical management of patients with critical illness of Covid-19.
Highlights
The clinical correlates, prognosis and determinants of acute kidney injury (AKI) in patients with coronavirus disease 2019 (Covid-19) remain largely unclear
Patients We reviewed medical records of all adult patients (> 18 years) with laboratory-confirmed Covid-19 who were admitted to the intensive care unit (ICU) between January 23rd 2020 and April 6th 2020 at Wuhan JinYinTan Hospital and The First Affiliated Hospital of Guangzhou Medical University
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA was detected by using reversetranscription polymerase chain reaction (RT-PCR) for laboratory diagnosis of Covid-19
Summary
The clinical correlates, prognosis and determinants of acute kidney injury (AKI) in patients with coronavirus disease 2019 (Covid-19) remain largely unclear. Since December 2019, the outbreak of coronavirus disease 2019 (Covid-19) has resulted in over 30.6 million laboratory-confirmed cases and 950,000 death cases worldwide as of September 20th 2020 [1]. The clinical manifestations of Covid-19 have been heterogeneous, ranging from asymptomatic viral carriers to critically ill cases [2, 3]. The clinical outcomes of critically ill patients have been poor, with the mortality rate being 61.5% within 28 days [4]. Previous studies have documented that greater age and the presence of comorbidities correlated significantly with death in patients with Covid-19 [5]. Few studies have focused on the systemic complications and the clinical outcomes of Covid-19
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