AKI in Hospitalized Patients with COVID-19.

Sep 7, 2020

Contributor: Lili Chan,Kumardeep Chaudhary,Aparna Saha,Kinsuk Chauhan,Akhil Vaid,Shan Zhao,Ishan Paranjpe,Sulaiman Somani,Felix Richter,Riccardo Miotto,Anuradha Lala,Arash Kia,Prem Timsina,Li Li,Robert Freeman,Rong Chen,Jagat Narula,Allan C Just,Carol Horowitz,Zahi Fayad,Carlos Cordon-Cardo,Eric Schadt,Matthew A Levin,David L Reich,Valentin Fuster,Barbara Murphy,John C He,Alexander W Charney,Erwin P Böttinger,Benjamin S Glicksberg,Steven G Coca,Girish N Nadkarni, ,Li Li

AKI in Hospitalized Patients with COVID-19.

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.
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.
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.
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.

Copyright © 2020 by the American Society of Nephrology.

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About The Expert

Lili Chan

Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

BioMe Phenomics Center, Icahn School of Medicine at Mount Sinai, New York, New York.

Kumardeep Chaudhary

The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

BioMe Phenomics Center, Icahn School of Medicine at Mount Sinai, New York, New York.

Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.

Aparna Saha

The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

BioMe Phenomics Center, Icahn School of Medicine at Mount Sinai, New York, New York.

Kinsuk Chauhan

Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Akhil Vaid

The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York.

Shan Zhao

The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York.

Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Ishan Paranjpe

The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York.

Sulaiman Somani

The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York.

Felix Richter

Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.

The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York.

Riccardo Miotto

Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.

The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York.

Anuradha Lala

Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.

Arash Kia

Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.

Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York.

Prem Timsina

Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.

Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York.

Li Li

Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.

Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, New York.

Robert Freeman

Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.

Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York.

Rong Chen

Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.

Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, New York.

Jagat Narula

Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York.

Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York.

Allan C Just

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York.

Carol Horowitz

Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.

Zahi Fayad

BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York.

Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York.

Carlos Cordon-Cardo

Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York.

Eric Schadt

Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.

Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, New York.

Matthew A Levin

Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

David L Reich

Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Valentin Fuster

The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.

Barbara Murphy

Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

John C He

Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Alexander W Charney

Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.

The Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, New York.

Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.

Erwin P Böttinger

The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York.

Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany.

Benjamin S Glicksberg

Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.

The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York.

Steven G Coca

Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York steven.coca@mssm.edu girish.nadkarni@mountsinai.org.

Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Girish N Nadkarni

Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York steven.coca@mssm.edu girish.nadkarni@mountsinai.org.

Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

BioMe Phenomics Center, Icahn School of Medicine at Mount Sinai, New York, New York.

The Hasso Plattner Institute for Digital Health at Mount Sinai, New York, New York.

Li Li

References

PubMed