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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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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. |
format | Online Article Text |
id | pubmed-8197451 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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