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Comparison of Acute Kidney Injury in Patients with COVID-19 and Other Respiratory Infections: A Prospective Cohort Study

Previous studies have indicated an association between coronavirus disease 2019 (COVID-19) and acute kidney injury (AKI) but lacked a control group. The prospective observational COronaVIrus-surviVAl (COVIVA) study performed at the University Hospital, Basel, Switzerland consecutively enrolled patie...

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Autores principales: Diebold, Matthias, Zimmermann, Tobias, Dickenmann, Michael, Schaub, Stefan, Bassetti, Stefano, Tschudin-Sutter, Sarah, Bingisser, Roland, Heim, Corin, Siegemund, Martin, Osswald, Stefan, Kuster, Gabriela M., Rentsch, Katharina M., Breidthardt, Tobias, Twerenbold, Raphael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8197451/
https://www.ncbi.nlm.nih.gov/pubmed/34070339
http://dx.doi.org/10.3390/jcm10112288
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author Diebold, Matthias
Zimmermann, Tobias
Dickenmann, Michael
Schaub, Stefan
Bassetti, Stefano
Tschudin-Sutter, Sarah
Bingisser, Roland
Heim, Corin
Siegemund, Martin
Osswald, Stefan
Kuster, Gabriela M.
Rentsch, Katharina M.
Breidthardt, Tobias
Twerenbold, Raphael
author_facet Diebold, Matthias
Zimmermann, Tobias
Dickenmann, Michael
Schaub, Stefan
Bassetti, Stefano
Tschudin-Sutter, Sarah
Bingisser, Roland
Heim, Corin
Siegemund, Martin
Osswald, Stefan
Kuster, Gabriela M.
Rentsch, Katharina M.
Breidthardt, Tobias
Twerenbold, Raphael
author_sort Diebold, Matthias
collection PubMed
description Previous studies have indicated an association between coronavirus disease 2019 (COVID-19) and acute kidney injury (AKI) but lacked a control group. The prospective observational COronaVIrus-surviVAl (COVIVA) study performed at the University Hospital, Basel, Switzerland consecutively enrolled patients with symptoms suggestive of COVID-19. We compared patients who tested positive for SARS-CoV-2 with patients who tested negative but with an adjudicated diagnosis of a respiratory tract infection, including pneumonia. The primary outcome measure was death at 30 days, and the secondary outcomes were AKI incidence and a composite endpoint of death, intensive care treatment or rehospitalization at 30 days. Five hundred and seven patients were diagnosed with respiratory tract infections, and of those, 183 (36%) had a positive PCR swab test for SARS-CoV-2. The incidence of AKI was higher in patients with COVID-19 (30% versus 12%, p < 0.001), more severe (KDIGO stage 3, 22% versus 13%, p = 0.009) and more often required renal replacement therapy (4.4% versus 0.93%; p = 0.03). The risk of 30-day mortality and a composite endpoint was higher in patients with COVID-19-associated AKI (adjusted hazard ratio (aHR) mortality 3.98, 95% confidence interval (CI) 1.10–14.46, p = 0.036; composite endpoint aHR 1.84, 95% CI 1.02–3.31, p = 0.042). The mortality risk was attenuated when adjusting for disease severity (aHR 3.60, 95% CI 0.93–13.96, p = 0.062). AKI occurs more frequently and with a higher severity in patients with COVID-19 and is associated with worse outcomes.
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spelling pubmed-81974512021-06-13 Comparison of Acute Kidney Injury in Patients with COVID-19 and Other Respiratory Infections: A Prospective Cohort Study Diebold, Matthias Zimmermann, Tobias Dickenmann, Michael Schaub, Stefan Bassetti, Stefano Tschudin-Sutter, Sarah Bingisser, Roland Heim, Corin Siegemund, Martin Osswald, Stefan Kuster, Gabriela M. Rentsch, Katharina M. Breidthardt, Tobias Twerenbold, Raphael J Clin Med Article Previous studies have indicated an association between coronavirus disease 2019 (COVID-19) and acute kidney injury (AKI) but lacked a control group. The prospective observational COronaVIrus-surviVAl (COVIVA) study performed at the University Hospital, Basel, Switzerland consecutively enrolled patients with symptoms suggestive of COVID-19. We compared patients who tested positive for SARS-CoV-2 with patients who tested negative but with an adjudicated diagnosis of a respiratory tract infection, including pneumonia. The primary outcome measure was death at 30 days, and the secondary outcomes were AKI incidence and a composite endpoint of death, intensive care treatment or rehospitalization at 30 days. Five hundred and seven patients were diagnosed with respiratory tract infections, and of those, 183 (36%) had a positive PCR swab test for SARS-CoV-2. The incidence of AKI was higher in patients with COVID-19 (30% versus 12%, p < 0.001), more severe (KDIGO stage 3, 22% versus 13%, p = 0.009) and more often required renal replacement therapy (4.4% versus 0.93%; p = 0.03). The risk of 30-day mortality and a composite endpoint was higher in patients with COVID-19-associated AKI (adjusted hazard ratio (aHR) mortality 3.98, 95% confidence interval (CI) 1.10–14.46, p = 0.036; composite endpoint aHR 1.84, 95% CI 1.02–3.31, p = 0.042). The mortality risk was attenuated when adjusting for disease severity (aHR 3.60, 95% CI 0.93–13.96, p = 0.062). AKI occurs more frequently and with a higher severity in patients with COVID-19 and is associated with worse outcomes. MDPI 2021-05-25 /pmc/articles/PMC8197451/ /pubmed/34070339 http://dx.doi.org/10.3390/jcm10112288 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Diebold, Matthias
Zimmermann, Tobias
Dickenmann, Michael
Schaub, Stefan
Bassetti, Stefano
Tschudin-Sutter, Sarah
Bingisser, Roland
Heim, Corin
Siegemund, Martin
Osswald, Stefan
Kuster, Gabriela M.
Rentsch, Katharina M.
Breidthardt, Tobias
Twerenbold, Raphael
Comparison of Acute Kidney Injury in Patients with COVID-19 and Other Respiratory Infections: A Prospective Cohort Study
title Comparison of Acute Kidney Injury in Patients with COVID-19 and Other Respiratory Infections: A Prospective Cohort Study
title_full Comparison of Acute Kidney Injury in Patients with COVID-19 and Other Respiratory Infections: A Prospective Cohort Study
title_fullStr Comparison of Acute Kidney Injury in Patients with COVID-19 and Other Respiratory Infections: A Prospective Cohort Study
title_full_unstemmed Comparison of Acute Kidney Injury in Patients with COVID-19 and Other Respiratory Infections: A Prospective Cohort Study
title_short Comparison of Acute Kidney Injury in Patients with COVID-19 and Other Respiratory Infections: A Prospective Cohort Study
title_sort comparison of acute kidney injury in patients with covid-19 and other respiratory infections: a prospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8197451/
https://www.ncbi.nlm.nih.gov/pubmed/34070339
http://dx.doi.org/10.3390/jcm10112288
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