Impact of cardiac and acute kidney injury on COVID-19 in-hospital mortality

BACKGROUND AND AIM: The severity of Coronavirus Disease 2019 (COVID-19) is a multifactorial condition. Cardiac and acute kidney injury (AKI) are two complications commonly reported in severe forms of COVID-19. We aimed to investigate the effect of these tow complications on the COVID-19 in-hospital mortality. MATERIALS AND METHODS: This is a prospective study, including 120 severe cases of COVID-19, admitted at the university hospital of Blida. Troponin was assessed by an immuno-fluoroassay method. AKI was defined according to the KDIGO-2012 guidelines. The association with in-hospital mortality was assessed using the Kaplan–Meier survival curve, proportional Cox regression analyses and the receiver operating characteristic curve. RESULTS: Cardiac and acute kidney injury were very common, occurring in 19% and 25% of patients. When analyzing survival, both were significantly associated with in-hospital mortality (p(LogRank) < 0.0001). A cutoff value of 9.6 ng/mL for troponin and 13.9 mg/L for creatinine could predict poor prognosis with a sensitivity of 73% and 67%, and a specificity of 62% and 64%, respectively. Hazard ratios were (HR = 3.5, 95% CI [1.7–7.3], P = 0.001 and HR = 3.14, 95% CI [1.6–6.1], P = 0.001) for troponin cutoff and AKI respectively. CONCLUSION: This study demonstrates the high frequency of cardiac and acute kidney injury in severe COVID-19 patients and provides further evidence of their potential link to poor short-term prognosis.