conducted a large study in metropolitan New York and found that almost 40% of patients developed AKI, which was strongly associated with mechanical ventilation and mortality, especially in patients admitted to the intensive care unit (ICU). More recent data from the United States show a much higher prevalence. Some initial studies from China showed a variable prevalence of AKI in patients with COVID-19.
Acute kidney injury (AKI) has now become a hallmark of COVID-19 and a major risk factor associated with mortality in hospitalized patients. COVID-19 is not only a lung disease but also has a deleterious impact on multiple organ systems, including cardiovascular, nervous, coagulation, and skin, in the setting of severe inflammation and cytokine release. Karger AG, BaselĬoronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly evolved into a global pandemic associated with devastating morbidity and mortality in hospitalized patients. Conclusion: Proteinuria and hematuria both at the time of admission and during hospitalization are associated with adverse clinical outcomes in hospitalized patients with COVID-19. In-hospital AKI increased (OR 27.14, 95% CI 4.44–240.17) while recovery from in-hospital AKI decreased the risk of death (OR 0.001, 95% CI 0.001–0.06). During hospitalization, de novo proteinuria was significantly associated with increased risk of death (OR 8.94, 95% CI 1.19–114.4, p = 0.04). Multivariable analysis demonstrated that admission proteinuria was significantly associated with risk of in-hospital AKI (OR 4.71, 95% CI 1.28–17.38), while admission hematuria was associated with ICU admission (OR 4.56, 95% CI 1.12–18.64), IMV (OR 8.79, 95% CI 2.08–37.00), and death (OR 18.03, 95% CI 2.84–114.57). Results: Three hundred patients met the inclusion criteria for the study cohort. We used ANOVA, t test, χ 2 test, and Fisher’s exact test for bivariate analyses and logistic regression for multivariable analysis. We investigated the association of proteinuria, hematuria, and AKI with outcomes of inflammation, intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and in-hospital death. Methods: This retrospective cohort study aimed to analyze these associations in 321 patients sequentially admitted between Maand Apat Stony Brook University Medical Center, New York. In addition, admission and in-hospital measures for kidney abnormalities have not been studied separately.
Introduction: Acute kidney injury (AKI) is strongly associated with poor outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19), but data on the association of proteinuria and hematuria are limited to non-US populations.
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