Acute Kidney Injury in Non-Intensive Care Unit (ICU) Hospitalizations for Coronavirus Disease (COVID-19)
Background: Acute kidney injury (AKI) is a common complication among SARS-CoV-2-positive patients who undergo hospitalization. Abundant evidence exists concerning the epidemiology of AKI in patients hospitalized in the ICU for COVID-19 but limited data are available about the occurrence of AKI in SA...
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| Format: | Article |
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MDPI AG
2022-10-01
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| Series: | Pathogens |
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| Online Access: | https://www.mdpi.com/2076-0817/11/11/1272 |
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| author | Fabrizio Fabrizi Carlo M. Alfieri Paolo Molinari Francesco Tamborini Marianna Tangredi Anna Sikharulidze Francesco Blasi Anna Fracanzani Walter Monzani Flora Peyvandi Giuseppe Castellano |
| author_facet | Fabrizio Fabrizi Carlo M. Alfieri Paolo Molinari Francesco Tamborini Marianna Tangredi Anna Sikharulidze Francesco Blasi Anna Fracanzani Walter Monzani Flora Peyvandi Giuseppe Castellano |
| author_sort | Fabrizio Fabrizi |
| collection | DOAJ |
| description | Background: Acute kidney injury (AKI) is a common complication among SARS-CoV-2-positive patients who undergo hospitalization. Abundant evidence exists concerning the epidemiology of AKI in patients hospitalized in the ICU for COVID-19 but limited data are available about the occurrence of AKI in SARS-CoV-2-positive patients being hospitalized in a non-ICU setting. Aim and Methods: We have carried out a retrospective study to evaluate frequency and risk factors for AKI among patients consecutively admitted at a third-level university hospital starting from February 2020 (the beginning of the first wave of the SARS-CoV-2 pandemic); all patients were hospitalized outside the ICU. Results: A total of 387 SARS-CoV-2-positive patients were included in the current study; 372 (96.1%) had SARS-CoV-2-related pneumonia. In-hospital AKI onset was recorded in 119 (30.7%) patients, mainly with AKI stage 1 (<i>n</i> = 74, 62.2%); eighteen (4.6%) patients reported AKI stage 3 and six (1.5%) patients had HD-dependent AKI. There were 235 (60.7%) patients with severe COVID-19, and this was more common in patients developing AKI, 94.5% (86/119) vs. 86.1% (149/268), <i>p =</i> 0.02. Multivariate regression model (<i>n</i> = 144 patients) reported an independent and significant relationship between AKI occurrence and greater levels of ferritin (<i>p =</i> 0.036), IL-6 (<i>p =</i> 0.032), and azotemia at admission (<i>p</i> = 0.0001). A total of 69 (17.8%) SARS-CoV-2-positive patients died and strong predictors of in-hospital death resulted from age (<i>p</i> < 0.0001), serum ferritin (<i>p</i> < 0.0001) and white blood cells (<i>p</i> < 0.001). According to multivariable analysis (<i>n</i> = 163 patients), there was a consistent link between in-hospital death and AKI stage (1) (<i>p</i> = 0.021) and -stage (2) (<i>p</i> = 0.009). Our results support the notion that AKI occurs frequently among hospitalized COVID-19 patients even in a non-ICU setting and plays a pivotal role in the mortality of this population. Further studies are ongoing in order to clearly establish the frequency of AKI in patients with COVID-19; the mechanisms underlying kidney injury in this population are an area of active investigation. These data provide solid evidence to support close monitoring of COVID-19 patients for the development of AKI and measures taken to prevent this. |
| first_indexed | 2024-03-09T18:45:45Z |
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| institution | Directory Open Access Journal |
| issn | 2076-0817 |
| language | English |
| last_indexed | 2024-03-09T18:45:45Z |
| publishDate | 2022-10-01 |
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| record_format | Article |
| series | Pathogens |
| spelling | doaj.art-1a569736ea054b039cd5b1199af26c432023-11-24T06:16:52ZengMDPI AGPathogens2076-08172022-10-011111127210.3390/pathogens11111272Acute Kidney Injury in Non-Intensive Care Unit (ICU) Hospitalizations for Coronavirus Disease (COVID-19)Fabrizio Fabrizi0Carlo M. Alfieri1Paolo Molinari2Francesco Tamborini3Marianna Tangredi4Anna Sikharulidze5Francesco Blasi6Anna Fracanzani7Walter Monzani8Flora Peyvandi9Giuseppe Castellano10Division of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milano, ItalyDivision of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milano, ItalyDivision of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milano, ItalyDivision of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milano, ItalyDivision of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milano, ItalyDivision of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milano, ItalyRespiratory Unit and Adult Cystic Fibrosis Center, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Pathophysiology and Transplantation, University School of Medicine, 20122 Milano, ItalyDivision of Sub-Intensive Care Medicine, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milano, ItalyDepartment of Pathophysiology and Transplantation, University School of Medicine, 20122 Milano, ItalyDivision of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milano, ItalyBackground: Acute kidney injury (AKI) is a common complication among SARS-CoV-2-positive patients who undergo hospitalization. Abundant evidence exists concerning the epidemiology of AKI in patients hospitalized in the ICU for COVID-19 but limited data are available about the occurrence of AKI in SARS-CoV-2-positive patients being hospitalized in a non-ICU setting. Aim and Methods: We have carried out a retrospective study to evaluate frequency and risk factors for AKI among patients consecutively admitted at a third-level university hospital starting from February 2020 (the beginning of the first wave of the SARS-CoV-2 pandemic); all patients were hospitalized outside the ICU. Results: A total of 387 SARS-CoV-2-positive patients were included in the current study; 372 (96.1%) had SARS-CoV-2-related pneumonia. In-hospital AKI onset was recorded in 119 (30.7%) patients, mainly with AKI stage 1 (<i>n</i> = 74, 62.2%); eighteen (4.6%) patients reported AKI stage 3 and six (1.5%) patients had HD-dependent AKI. There were 235 (60.7%) patients with severe COVID-19, and this was more common in patients developing AKI, 94.5% (86/119) vs. 86.1% (149/268), <i>p =</i> 0.02. Multivariate regression model (<i>n</i> = 144 patients) reported an independent and significant relationship between AKI occurrence and greater levels of ferritin (<i>p =</i> 0.036), IL-6 (<i>p =</i> 0.032), and azotemia at admission (<i>p</i> = 0.0001). A total of 69 (17.8%) SARS-CoV-2-positive patients died and strong predictors of in-hospital death resulted from age (<i>p</i> < 0.0001), serum ferritin (<i>p</i> < 0.0001) and white blood cells (<i>p</i> < 0.001). According to multivariable analysis (<i>n</i> = 163 patients), there was a consistent link between in-hospital death and AKI stage (1) (<i>p</i> = 0.021) and -stage (2) (<i>p</i> = 0.009). Our results support the notion that AKI occurs frequently among hospitalized COVID-19 patients even in a non-ICU setting and plays a pivotal role in the mortality of this population. Further studies are ongoing in order to clearly establish the frequency of AKI in patients with COVID-19; the mechanisms underlying kidney injury in this population are an area of active investigation. These data provide solid evidence to support close monitoring of COVID-19 patients for the development of AKI and measures taken to prevent this.https://www.mdpi.com/2076-0817/11/11/1272acute kidney injurychronic kidney diseaseCOVID-19deathSARS-CoV-2 |
| spellingShingle | Fabrizio Fabrizi Carlo M. Alfieri Paolo Molinari Francesco Tamborini Marianna Tangredi Anna Sikharulidze Francesco Blasi Anna Fracanzani Walter Monzani Flora Peyvandi Giuseppe Castellano Acute Kidney Injury in Non-Intensive Care Unit (ICU) Hospitalizations for Coronavirus Disease (COVID-19) Pathogens acute kidney injury chronic kidney disease COVID-19 death SARS-CoV-2 |
| title | Acute Kidney Injury in Non-Intensive Care Unit (ICU) Hospitalizations for Coronavirus Disease (COVID-19) |
| title_full | Acute Kidney Injury in Non-Intensive Care Unit (ICU) Hospitalizations for Coronavirus Disease (COVID-19) |
| title_fullStr | Acute Kidney Injury in Non-Intensive Care Unit (ICU) Hospitalizations for Coronavirus Disease (COVID-19) |
| title_full_unstemmed | Acute Kidney Injury in Non-Intensive Care Unit (ICU) Hospitalizations for Coronavirus Disease (COVID-19) |
| title_short | Acute Kidney Injury in Non-Intensive Care Unit (ICU) Hospitalizations for Coronavirus Disease (COVID-19) |
| title_sort | acute kidney injury in non intensive care unit icu hospitalizations for coronavirus disease covid 19 |
| topic | acute kidney injury chronic kidney disease COVID-19 death SARS-CoV-2 |
| url | https://www.mdpi.com/2076-0817/11/11/1272 |
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