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Longitudinal Clinical Profiles of Hospital vs. Community-Acquired Acute Kidney Injury in COVID-19.
Lu, Justin Y; Babatsikos, Ioannis; Fisher, Molly C; Hou, Wei; Duong, Tim Q.
  • Lu JY; Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, United States.
  • Babatsikos I; Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, United States.
  • Fisher MC; Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States.
  • Hou W; Division of Nephrology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, United States.
  • Duong TQ; Department of Family, Population & Preventive Medicine, Stony Brook Medicine, New York, NY, United States.
Front Med (Lausanne) ; 8: 647023, 2021.
Article in English | MEDLINE | ID: covidwho-1268258
ABSTRACT
Acute kidney injury (AKI) is associated with high mortality in coronavirus disease 2019 (COVID-19). However, it is unclear whether patients with COVID-19 with hospital-acquired AKI (HA-AKI) and community-acquired AKI (CA-AKI) differ in disease course and outcomes. This study investigated the clinical profiles of HA-AKI, CA-AKI, and no AKI in patients with COVID-19 at a large tertiary care hospital in the New York City area. The incidence of HA-AKI was 23.26%, and CA-AKI was 22.28%. Patients who developed HA-AKI were older and had more comorbidities compared to those with CA-AKI and those with no AKI (p < 0.05). A higher prevalence of coronary artery disease, heart failure, and chronic kidney disease was observed in those with HA-AKI compared to those with CA-AKI (p < 0.05). Patients with CA-AKI received more invasive and non-invasive mechanical ventilation, anticoagulants, and steroids compared to those with HA-AKI (p < 0.05), but patients with HA-AKI had significantly higher mortality compared to those with CA-AKI after adjusting for demographics and clinical comorbidities (adjusted odds ratio = 1.61, 95% confidence interval = 1.1-2.35, p < 0.014). In addition, those with HA-AKI had higher markers of inflammation and more liver injury (p < 0.05) compared to those with CA-AKI. These results suggest that HA-AKI is likely part of systemic multiorgan damage and that kidney injury contributes to worse outcomes. These findings provide insights that could lead to better management of COVID-19 patients in time-sensitive and potentially resource-constrained environments.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.647023

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.647023