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OBJECTIVE@#To assess the predictors and outcomes of acute kidney injury (AKI) among patients with coronavirus disease 2019 (COVID-19).@*OBJECTIVE@#This retrospective observational study was conducted among patients with a confirmed diagnosis of COVID-19 admitted to Hankou Hospital between January, 5 and March 8, 2020. We evaluated the association of AKI with the demographic and biochemical parameters and clinical outcomes of the patients using univariate regression analysis.@*OBJECTIVE@#Atotal of 287 COVID-19 patients, including 55 with AKI and 232 without AKI, were included in the analysis. Compared with the patients without AKI, the patients with AKI were older, predominantly male, and were more likely to have hypoxia and pre-existing hypertension and cerebrovascular diseases. The patients with AKI also had higher levels of white blood cells, D-dimer, aspartate aminotransferase, total bilirubin, creatine kinase, lactate dehydrogenase, procalcitonin, C-reactive protein, a higher prevalence of hyperkalemia, lower lymphocyte counts, and higher chest computed tomographic scores. The incidence of stage 1 AKI was 14.3% and that of stage 2 or 3 AKI was 4.9%. The patients with AKI had much higher mortality rate than those without AKI.@*OBJECTIVE@#AKI is an important complication of COVID-19. An older age, a male gender, multiple pre- existing comorbidities, lymphopenia, increased infection indicators, elevated D-dimer, and impaired heart and liver functions are all potential risk factors ofAKI. COVID- 19 patients with AKI that progresses into stages 2 or 3 AKI have a high mortality rate. Prevention of AKI and monitoring kidney function is critical in the care of COVID-19 patients.
Subject(s)
Aged , Humans , Male , Acute Kidney Injury/epidemiology , COVID-19 , China/epidemiology , Retrospective Studies , SARS-CoV-2ABSTRACT
Objectives To explore the nutritional status of vitamin A in healthy children and children with respiratory infection symptoms, and its correlation with hemoglobin levels. Methods Health children who lived in Beijing for over half year during December 2014 to August 2015 were included. Serum retinol and peripheral blood hemoglobin were measured. The relationship of vitamin A nutritional status with age, respiratory tract infection and anemia were analyzed. Results A total of 1742 children (1056 males and 686 females) with a median age of 3.1 years (6 months~17 years) were enrolled. 202 children had respiratory tract infection and 1540 children didn't have respiratory tract infection when visiting. The median serum retinol level was 0.29 mg/L (0.25~0.33 mg/L) in all children. The level of retinol in children with respiratory tract symptoms was significantly lower than that in children without respiratory symptoms (P<0.001). The prevalence of subclinical vitamin A deficiency and suspected subclinical deficiency were 5.8% and 47.9% respectively. The prevalence of both the subclinical and suspected subclinical vitamin A deficiency ratios were >50% in children under 9-year-old. The prevalence of subclinical vitamin A deficiency and suspected subclinical deficiency among different age groups were statistically different (P<0.001). The incidence of anemia in subclinical vitamin A deficiency, suspected subclinical deficiency children and normal children were 3.9%, 8.7%, and 10.8% respectively, and The differences were statistically significant (P<0.01). Serum retinol and hemoglobin concentrations were positively correlated with age (r=0.179 or 0.571, P all < 0.001). Furthermore, serum retinol was positively correlated with the concentration of hemoglobin (r=0.244, P<0.001). Conclusions Serum retinol level in children with respiratory infection is lower than that in healthy children. Vitamin A deficiency was associated with anemia.
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Objectives To explore the nutritional status of vitamin A in healthy children and children with respiratory infection symptoms, and its correlation with hemoglobin levels. Methods Health children who lived in Beijing for over half year during December 2014 to August 2015 were included. Serum retinol and peripheral blood hemoglobin were measured. The relationship of vitamin A nutritional status with age, respiratory tract infection and anemia were analyzed. Results A total of 1742 children (1056 males and 686 females) with a median age of 3.1 years (6 months~17 years) were enrolled. 202 children had respiratory tract infection and 1540 children didn't have respiratory tract infection when visiting. The median serum retinol level was 0.29 mg/L (0.25~0.33 mg/L) in all children. The level of retinol in children with respiratory tract symptoms was significantly lower than that in children without respiratory symptoms (P<0.001). The prevalence of subclinical vitamin A deficiency and suspected subclinical deficiency were 5.8% and 47.9% respectively. The prevalence of both the subclinical and suspected subclinical vitamin A deficiency ratios were >50% in children under 9-year-old. The prevalence of subclinical vitamin A deficiency and suspected subclinical deficiency among different age groups were statistically different (P<0.001). The incidence of anemia in subclinical vitamin A deficiency, suspected subclinical deficiency children and normal children were 3.9%, 8.7%, and 10.8% respectively, and The differences were statistically significant (P<0.01). Serum retinol and hemoglobin concentrations were positively correlated with age (r=0.179 or 0.571, P all < 0.001). Furthermore, serum retinol was positively correlated with the concentration of hemoglobin (r=0.244, P<0.001). Conclusions Serum retinol level in children with respiratory infection is lower than that in healthy children. Vitamin A deficiency was associated with anemia.
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Objective To explore rules of changes in velocity of ultrasound wave transmission at the tibia and radius by a quantitative bone mineral density ultrasound scanner in examination of early incipient rickets in infants and its significance in clinical diagnosis.Methods One hundred and fifty-seven infants who visited child health-care clinic of the Capital Institute of Pediatrics,Beijing during May 2004 to December 2007 and clinically diagnosed as rickets according to the Criteria of Diagnosis for Rickets in Infants and Young Children formulated in 1986 by the Ministry of Health,as well as 124 normal healthy infants as controls,were enrolled in the study and followed-up for three months.Velocity of ultrasound wave transmission at the tibia and radius in all the infants were measured by a bone mineral density ultrasound scanner (Sunlight Omnisense 7000R made in Israel).Results One hundred and fifty-seven infants were clinically diagnosed as rickets,127 of them undergone with carpal plane roentgenography and 90 of the 127 with positive change in bone x-ray imaging and 37 without it.Velocity of ultrasound wave transmission at the tibia and radius measured by z-score was significantly lower in infants with clinically diagnosed rickets than that in healthy controls (Z-values of-10.411 and-10.399 at the tibia and-5.646 and-5.517 at the radius,respectively,P = 0.000 with Mann-Whitney test).Velocity of ultrasound wave transmission at the tibia and radius measured by z-score was lower in those with positive change in x-my imaging than that in those without it,but not reaching a level of statistically significant difference.Velocity of ultrasound wave transmission and z-score correlated positively with change in bone x-ray imaging,respectively with Spearman coefficients of correlation of 0.581 and 0.677 for tibia,0.316 and 0.467 for radius (P = 0.000).Receiver operating characteristic (ROC) curve was drawn from those with rickets and positive left carpal plane roetgenograph.Area under curve of ROC for z-score of velocity of ultrasound wave transmission at the tibia was 0.812 and 0.799 (95% CI 0.758-0.856 and 0.742-0.855,P =0.000),respectively.Area under ROC curve of z-score of velocity of ultrasound wave transmission at the radius was 0.715 and 0.697 (95% CI 0.650-0.780,0.631-0.764,P =0.000),respectively.Cut-off value of z-score was-205--1.95 at the tibia,according to the largest sensitivity and the least false-positivity,with sensibility of 0.8 to 0.9 and specificity of 0.733 to 0.702.As its sensitivity at the radius was more than 0.7,its specificity was lower than 0.524.Conclusions Quantitative ultrasound scanning can be used to detect insufficient bone mineral density in infants and their early skeletal change by rickets but without change in bone x-ray imaging.Velocity of ultrasound wave transmission at the tibia can be used as an indicator to predict early rickets in infants rather than its severity.