TY - JOUR
T1 - AKI in hospitalized patients with COVID-19
AU - on behalf of the Mount Sinai COVID Informatics Center (MSCIC)
AU - Chan, Lili
AU - Chaudhary, Kumardeep
AU - Saha, Aparna
AU - Chauhan, Kinsuk
AU - Vaid, Akhil
AU - Zhao, Shan
AU - Paranjpe, Ishan
AU - Somani, Sulaiman
AU - Richter, Felix
AU - Miotto, Riccardo
AU - Lala, Anuradha
AU - Kia, Arash
AU - Timsina, Prem
AU - Li, Li
AU - Freeman, Robert
AU - Chen, Rong
AU - Narula, Jagat
AU - Just, Allan C.
AU - Horowitz, Carol
AU - Fayad, Zahi
AU - Cordon-Cardo, Carlos
AU - Schadt, Eric
AU - Levin, Matthew A.
AU - Reich, David L.
AU - Fuster, Valentin
AU - Murphy, Barbara
AU - He, John C.
AU - Charney, Alexander W.
AU - Böttinger, Erwin P.
AU - Glicksberg, Benjamin S.
AU - Coca, Steven G.
AU - Nadkarni, Girish N.
N1 - Publisher Copyright:
Copyright © 2021 by the American Society of Nephrology.
PY - 2021/1
Y1 - 2021/1
N2 - Background Early reports indicate that AKI is common among patients with coronavirus disease 2019 (COVID-19) and associated with worse outcomes. However, AKI among hospitalized patients with COVID-19 in the United States is not well described. Methods This retrospective, observational study involved a review of data from electronic health records of patients aged $18 years with laboratory-confirmed COVID-19 admitted to the Mount Sinai Health System from February 27 to May 30, 2020. We describe the frequency of AKI and dialysis requirement, AKI recovery, and adjusted odds ratios (aORs) with mortality. Results Of 3993 hospitalized patients with COVID-19, AKI occurred in 1835 (46%) patients; 347 (19%) of the patients with AKI required dialysis. The proportions with stages 1, 2, or 3 AKI were 39%, 19%, and 42%, respectively. A total of 976 (24%) patients were admitted to intensive care, and 745 (76%) experienced AKI. Of the 435 patients with AKI and urine studies, 84% had proteinuria, 81% had hematuria, and 60% had leukocyturia. Independent predictors of severe AKI were CKD, men, and higher serum potassium at admission. In-hospital mortality was 50% among patients with AKI versus 8% among those without AKI (aOR, 9.2; 95% confidence interval, 7.5 to 11.3). Of survivors with AKI who were discharged, 35% had not recovered to baseline kidney function by the time of discharge. An additional 28 of 77 (36%) patients who had not recovered kidney function at discharge did so on posthospital follow-up. Conclusions AKI is common among patients hospitalized with COVID-19 and is associated with high mortality. Of all patients with AKI, only 30% survived with recovery of kidney function by the time of discharge.
AB - Background Early reports indicate that AKI is common among patients with coronavirus disease 2019 (COVID-19) and associated with worse outcomes. However, AKI among hospitalized patients with COVID-19 in the United States is not well described. Methods This retrospective, observational study involved a review of data from electronic health records of patients aged $18 years with laboratory-confirmed COVID-19 admitted to the Mount Sinai Health System from February 27 to May 30, 2020. We describe the frequency of AKI and dialysis requirement, AKI recovery, and adjusted odds ratios (aORs) with mortality. Results Of 3993 hospitalized patients with COVID-19, AKI occurred in 1835 (46%) patients; 347 (19%) of the patients with AKI required dialysis. The proportions with stages 1, 2, or 3 AKI were 39%, 19%, and 42%, respectively. A total of 976 (24%) patients were admitted to intensive care, and 745 (76%) experienced AKI. Of the 435 patients with AKI and urine studies, 84% had proteinuria, 81% had hematuria, and 60% had leukocyturia. Independent predictors of severe AKI were CKD, men, and higher serum potassium at admission. In-hospital mortality was 50% among patients with AKI versus 8% among those without AKI (aOR, 9.2; 95% confidence interval, 7.5 to 11.3). Of survivors with AKI who were discharged, 35% had not recovered to baseline kidney function by the time of discharge. An additional 28 of 77 (36%) patients who had not recovered kidney function at discharge did so on posthospital follow-up. Conclusions AKI is common among patients hospitalized with COVID-19 and is associated with high mortality. Of all patients with AKI, only 30% survived with recovery of kidney function by the time of discharge.
UR - http://www.scopus.com/inward/record.url?scp=85098576623&partnerID=8YFLogxK
U2 - 10.1681/ASN.2020050615
DO - 10.1681/ASN.2020050615
M3 - Article
C2 - 32883700
AN - SCOPUS:85098576623
SN - 1046-6673
VL - 32
SP - 151
EP - 160
JO - Journal of the American Society of Nephrology
JF - Journal of the American Society of Nephrology
IS - 1
ER -