Impact of cardiac and acute kidney injury on COVID-19 in-hospital mortality

ABSTRACT

Background and aim The severity of Coronavirus Disease 2019 (COVID-19) is a multifactorial condition. Cardiac and acute kidney injury (AKI) are two complications commonly reported in severe forms of COVID-19. We aimed to investigate the effect of these tow complications on the COVID-19 in-hospital mortality. Materials and methods This is a prospective study, including 120 severe cases of COVID-19, admitted at the university hospital of Blida. Troponin was assessed by an immuno-fluoroassay method. AKI was defined according to the KDIGO-2012 guidelines. The association with in-hospital mortality was assessed using the Kaplan–Meier survival curve, proportional Cox regression analyses and the receiver operating characteristic curve. Results Cardiac and acute kidney injury were very common, occurring in 19% and 25% of patients. When analyzing survival, both were significantly associated with in-hospital mortality (pLogRank<0.0001). A cutoff value of 9.6ng/mL for troponin and 13.9mg/L for creatinine could predict poor prognosis with a sensitivity of 73% and 67%, and a specificity of 62% and 64%, respectively. Hazard ratios were (HR=3.5, 95% CI [1.7–7.3], P=0.001 and HR=3.14, 95% CI [1.6–6.1], P=0.001) for troponin cutoff and AKI respectively. Conclusion This study demonstrates the high frequency of cardiac and acute kidney injury in severe COVID-19 patients and provides further evidence of their potential link to poor short-term prognosis.