tetano
Editor, Senior Moderator
J Am Soc Nephrol
. 2021 Jan 22;ASN.2020071097.
doi: 10.1681/ASN.2020071097. Online ahead of print.
Risks of AKI and Major Adverse Clinical Outcomes in Patients with Severe Acute Respiratory Syndrome or Coronavirus Disease 2019
Jeremy Yuen-Chun Teoh[SUP] 1 [/SUP], Terry Cheuk-Fung Yip[SUP] 2 3 [/SUP], Grace Chung-Yan Lui[SUP] 2 3 4 [/SUP], Vincent Wai-Sun Wong[SUP] 5 3 [/SUP], Viola Chi-Ying Chow[SUP] 6 [/SUP], Tracy Hang-Yee Ho[SUP] 5 [/SUP], Timothy Chun-Man Li[SUP] 2 [/SUP], Yee-Kit Tse[SUP] 2 3 [/SUP], Peter Ka-Fung Chiu[SUP] 1 [/SUP], Chi-Fai Ng[SUP] 7 [/SUP], David Shu-Cheong Hui[SUP] 2 3 4 [/SUP], Henry Lik-Yuen Chan[SUP] 2 3 [/SUP], Cheuk-Chun Szeto[SUP] 8 [/SUP], Grace Lai-Hung Wong[SUP] 5 3 [/SUP]
Affiliations
Abstract
Background: Severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) are closely related. The effect of AKI on the clinical outcomes of these two conditions is unclear.
Methods: This retrospective, territory-wide cohort study used an electronic public healthcare database in Hong Kong to identify patients with SARS or COVID-19 by diagnosis codes, virologic results, or both. The primary endpoint was a composite of intensive care unit admission, use of invasive mechanical ventilation, and/or death.
Results: We identified 1670 patients with SARS and 1040 patients with COVID-19 (median ages, 41 versus 35 years, respectively). Among patients with SARS, 26% met the primary endpoint versus 5.3% of those with COVID-19. Diabetes mellitus, abnormal liver function, and AKI were factors significantly associated with the primary endpoint among patients with either SARS or COVID-19. Among patients with SARS, 7.9%, 2.1%, and 3.7% developed stage 1, stage 2, and stage 3 AKI, respectively; among those with COVID-19, 6.6%, 0.4%, and 1.1% developed stage 1, stage 2, and stage 3 AKI, respectively. In both groups, factors significantly associated with AKI included diabetes mellitus and hypertension. Among patients with AKI, those with COVID-19 had a lower rate of major adverse clinical outcomes versus patients with SARS. Renal function recovery usually occurred within 30 days after an initial AKI event.
Conclusions: AKI rates were higher among patients with SARS than those with COVID-19. AKI was associated with major adverse clinical outcomes for both diseases. Patients with diabetes mellitus and abnormal liver function were also at risk of developing severe consequences after SARS and COVID-19 infection.
Keywords: COVID-19; kidney; kidney disease; kidney dysfunction; renal dysfunction; renal function decline; renal injury.
. 2021 Jan 22;ASN.2020071097.
doi: 10.1681/ASN.2020071097. Online ahead of print.
Risks of AKI and Major Adverse Clinical Outcomes in Patients with Severe Acute Respiratory Syndrome or Coronavirus Disease 2019
Jeremy Yuen-Chun Teoh[SUP] 1 [/SUP], Terry Cheuk-Fung Yip[SUP] 2 3 [/SUP], Grace Chung-Yan Lui[SUP] 2 3 4 [/SUP], Vincent Wai-Sun Wong[SUP] 5 3 [/SUP], Viola Chi-Ying Chow[SUP] 6 [/SUP], Tracy Hang-Yee Ho[SUP] 5 [/SUP], Timothy Chun-Man Li[SUP] 2 [/SUP], Yee-Kit Tse[SUP] 2 3 [/SUP], Peter Ka-Fung Chiu[SUP] 1 [/SUP], Chi-Fai Ng[SUP] 7 [/SUP], David Shu-Cheong Hui[SUP] 2 3 4 [/SUP], Henry Lik-Yuen Chan[SUP] 2 3 [/SUP], Cheuk-Chun Szeto[SUP] 8 [/SUP], Grace Lai-Hung Wong[SUP] 5 3 [/SUP]
Affiliations
- PMID: 33483314
- DOI: 10.1681/ASN.2020071097
Abstract
Background: Severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) are closely related. The effect of AKI on the clinical outcomes of these two conditions is unclear.
Methods: This retrospective, territory-wide cohort study used an electronic public healthcare database in Hong Kong to identify patients with SARS or COVID-19 by diagnosis codes, virologic results, or both. The primary endpoint was a composite of intensive care unit admission, use of invasive mechanical ventilation, and/or death.
Results: We identified 1670 patients with SARS and 1040 patients with COVID-19 (median ages, 41 versus 35 years, respectively). Among patients with SARS, 26% met the primary endpoint versus 5.3% of those with COVID-19. Diabetes mellitus, abnormal liver function, and AKI were factors significantly associated with the primary endpoint among patients with either SARS or COVID-19. Among patients with SARS, 7.9%, 2.1%, and 3.7% developed stage 1, stage 2, and stage 3 AKI, respectively; among those with COVID-19, 6.6%, 0.4%, and 1.1% developed stage 1, stage 2, and stage 3 AKI, respectively. In both groups, factors significantly associated with AKI included diabetes mellitus and hypertension. Among patients with AKI, those with COVID-19 had a lower rate of major adverse clinical outcomes versus patients with SARS. Renal function recovery usually occurred within 30 days after an initial AKI event.
Conclusions: AKI rates were higher among patients with SARS than those with COVID-19. AKI was associated with major adverse clinical outcomes for both diseases. Patients with diabetes mellitus and abnormal liver function were also at risk of developing severe consequences after SARS and COVID-19 infection.
Keywords: COVID-19; kidney; kidney disease; kidney dysfunction; renal dysfunction; renal function decline; renal injury.