Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney Injury
Fatal Outcomes of COVID-19 in Patients with Severe Acute Kidney Injury
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DOI：
10.3390/jcm9061718
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发表时间：
2020-06-01
影响因子：
3.9
通讯作者：
Kim, Yong-Lim
中科院分区：
文献类型：
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作者：
Lim, Jeong-Hoon;Park, Sun-Hee;Kim, Yong-Lim
冠状病毒病2019(新冠肺炎)的结局与器官损害有关；然而，关于急性肾脏损伤(AKI)与新冠肺炎之间的关系的信息仍然很少。我们根据急性KI的严重程度评估新冠肺炎急性KI患者的临床特点和预后。对韩国大邱暴发期间在两所大学医院住院的新冠肺炎患者的医疗数据进行了回顾分析。AKI及其严重程度根据急性肾损伤网络进行定义。在住院的164例新冠肺炎患者中，30例(18.3%)为急性肾功能衰竭，其中14例为1期，4例为2期，12例为3期。急性心肌梗死患者的中位年龄显著高于非急性心肌梗死患者(75.5vs.67.0岁，p=0.005)。急性心肌梗死死亡17例(56.7%)，死亡4例(28.6%)，死亡1例(25.0%)，死亡12例(100.0%)。急性心肌梗死患者的住院死亡率高于非急性心肌梗死患者(56.7%比20.8%，p<；0.001)。在调整了潜在的混杂因素后，第3期AKI的死亡率高于非AKI或第1期AKI(危险比(HR)=3.62(95%可信区间=1.75-7.48)，p=0.001；HR=15.65(95%CI=2.43-100.64)，p=0.004)。在AKI患者中，急性呼吸窘迫综合征和入院时低血清白蛋白被认为是3期AKI的独立危险因素(均P
The outcome of coronavirus disease 2019 (COVID-19) is associated with organ damage; however, the information about the relationship between acute kidney injury (AKI) and COVID-19 is still rare. We evaluated the clinical features and prognosis of COVID-19 patients with AKI according to the AKI severity. Medical data of hospitalized COVID-19 patients in two university-based hospitals during an outbreak in Daegu, South Korea, were retrospectively analyzed. AKI and its severity were defined according to the Acute Kidney Injury Network. Of the 164 hospitalized patients with COVID-19, 30 patients (18.3%) had AKI; 14, 4, and 12 patients had stage 1, 2, and 3, respectively. The median age was significantly higher in AKI patients than in non-AKI patients (75.5 vs. 67.0 years,p= 0.005). There were 17 deaths (56.7%) among AKI patients; 4 (28.6%), 1 (25.0%), and 12 (100.0%), respectively. In-hospital mortality was higher in AKI patients than in non-AKI patients (56.7% vs. 20.8%,p< 0.001). After adjusting for potential confounding factors, stage 3 AKI was associated with higher mortality than either non-AKI or stage 1 AKI (hazard ratio (HR) = 3.62 (95% confidence interval (CI) = 1.75-7.48),p= 0.001; HR = 15.65 (95% CI = 2.43-100.64),p= 0.004). Among the AKI patients, acute respiratory distress syndrome and low serum albumin on admission were considered independent risk factors for stage 3 AKI (bothp