Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney Injury
The outcome of coronavirus disease 2019 (COVID-19) is associated with organ damage; however, the information about the relationship between acute kidney injury (AKI) and COVID-19 is still rare. We evaluated the clinical features and prognosis of COVID-19 patients with AKI according to the AKI severi...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/6/1718 |
| _version_ | 1797566208982122496 |
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| author | Jeong-Hoon Lim Sun-Hee Park Yena Jeon Jang-Hee Cho Hee-Yeon Jung Ji-Young Choi Chan-Duck Kim Yong-Hoon Lee Hyewon Seo Jaehee Lee Ki Tae Kwon Shin-Woo Kim Hyun-Ha Chang Yong-Lim Kim |
| author_facet | Jeong-Hoon Lim Sun-Hee Park Yena Jeon Jang-Hee Cho Hee-Yeon Jung Ji-Young Choi Chan-Duck Kim Yong-Hoon Lee Hyewon Seo Jaehee Lee Ki Tae Kwon Shin-Woo Kim Hyun-Ha Chang Yong-Lim Kim |
| author_sort | Jeong-Hoon Lim |
| collection | DOAJ |
| description | The outcome of coronavirus disease 2019 (COVID-19) is associated with organ damage; however, the information about the relationship between acute kidney injury (AKI) and COVID-19 is still rare. We evaluated the clinical features and prognosis of COVID-19 patients with AKI according to the AKI severity. Medical data of hospitalized COVID-19 patients in two university-based hospitals during an outbreak in Daegu, South Korea, were retrospectively analyzed. AKI and its severity were defined according to the Acute Kidney Injury Network. Of the 164 hospitalized patients with COVID-19, 30 patients (18.3%) had AKI; 14, 4, and 12 patients had stage 1, 2, and 3, respectively. The median age was significantly higher in AKI patients than in non-AKI patients (75.5 vs. 67.0 years, <i>p</i> = 0.005). There were 17 deaths (56.7%) among AKI patients; 4 (28.6%), 1 (25.0%), and 12 (100.0%), respectively. In-hospital mortality was higher in AKI patients than in non-AKI patients (56.7% vs. 20.8%, <i>p</i> < 0.001). After adjusting for potential confounding factors, stage 3 AKI was associated with higher mortality than either non-AKI or stage 1 AKI (hazard ratio (HR) = 3.62 (95% confidence interval (CI) = 1.75–7.48), <i>p</i> = 0.001; HR = 15.65 (95% CI = 2.43–100.64), <i>p</i> = 0.004). Among the AKI patients, acute respiratory distress syndrome and low serum albumin on admission were considered independent risk factors for stage 3 AKI (both <i>p <</i> 0.05). Five patients with stage 3 AKI underwent dialysis and eventually died. In conclusion, COVID-19 patients with severe AKI had fatal outcomes. |
| first_indexed | 2024-03-10T19:23:26Z |
| format | Article |
| id | doaj.art-066f5aae28d04b37ac2fa44a4a4186ee |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T19:23:26Z |
| publishDate | 2020-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-066f5aae28d04b37ac2fa44a4a4186ee2023-11-20T02:43:01ZengMDPI AGJournal of Clinical Medicine2077-03832020-06-0196171810.3390/jcm9061718Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney InjuryJeong-Hoon Lim0Sun-Hee Park1Yena Jeon2Jang-Hee Cho3Hee-Yeon Jung4Ji-Young Choi5Chan-Duck Kim6Yong-Hoon Lee7Hyewon Seo8Jaehee Lee9Ki Tae Kwon10Shin-Woo Kim11Hyun-Ha Chang12Yong-Lim Kim13Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaDivision of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaDepartment of Statistics, Kyungpook National University, Daegu 41566, KoreaDivision of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaDivision of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaDivision of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaDivision of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaDivision of Pulmonology and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaDivision of Pulmonology and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaDivision of Pulmonology and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaDivision of Infectious Disease, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaDivision of Infectious Disease, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaDivision of Infectious Disease, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaDivision of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, KoreaThe outcome of coronavirus disease 2019 (COVID-19) is associated with organ damage; however, the information about the relationship between acute kidney injury (AKI) and COVID-19 is still rare. We evaluated the clinical features and prognosis of COVID-19 patients with AKI according to the AKI severity. Medical data of hospitalized COVID-19 patients in two university-based hospitals during an outbreak in Daegu, South Korea, were retrospectively analyzed. AKI and its severity were defined according to the Acute Kidney Injury Network. Of the 164 hospitalized patients with COVID-19, 30 patients (18.3%) had AKI; 14, 4, and 12 patients had stage 1, 2, and 3, respectively. The median age was significantly higher in AKI patients than in non-AKI patients (75.5 vs. 67.0 years, <i>p</i> = 0.005). There were 17 deaths (56.7%) among AKI patients; 4 (28.6%), 1 (25.0%), and 12 (100.0%), respectively. In-hospital mortality was higher in AKI patients than in non-AKI patients (56.7% vs. 20.8%, <i>p</i> < 0.001). After adjusting for potential confounding factors, stage 3 AKI was associated with higher mortality than either non-AKI or stage 1 AKI (hazard ratio (HR) = 3.62 (95% confidence interval (CI) = 1.75–7.48), <i>p</i> = 0.001; HR = 15.65 (95% CI = 2.43–100.64), <i>p</i> = 0.004). Among the AKI patients, acute respiratory distress syndrome and low serum albumin on admission were considered independent risk factors for stage 3 AKI (both <i>p <</i> 0.05). Five patients with stage 3 AKI underwent dialysis and eventually died. In conclusion, COVID-19 patients with severe AKI had fatal outcomes.https://www.mdpi.com/2077-0383/9/6/1718acute kidney injuryAKI severityCOVID-19mortalityrenal replacement therapy |
| spellingShingle | Jeong-Hoon Lim Sun-Hee Park Yena Jeon Jang-Hee Cho Hee-Yeon Jung Ji-Young Choi Chan-Duck Kim Yong-Hoon Lee Hyewon Seo Jaehee Lee Ki Tae Kwon Shin-Woo Kim Hyun-Ha Chang Yong-Lim Kim Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney Injury Journal of Clinical Medicine acute kidney injury AKI severity COVID-19 mortality renal replacement therapy |
| title | Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney Injury |
| title_full | Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney Injury |
| title_fullStr | Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney Injury |
| title_full_unstemmed | Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney Injury |
| title_short | Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney Injury |
| title_sort | fatal outcomes of covid 19 in patients with severe acute kidney injury |
| topic | acute kidney injury AKI severity COVID-19 mortality renal replacement therapy |
| url | https://www.mdpi.com/2077-0383/9/6/1718 |
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