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Long-term kidney function recovery and mortality after COVID-19-associated acute kidney injury: An international multi-centre observational cohort study.
Tan, Byorn W L; Tan, Bryce W Q; Tan, Amelia L M; Schriver, Emily R; Gutiérrez-Sacristán, Alba; Das, Priyam; Yuan, William; Hutch, Meghan R; García Barrio, Noelia; Pedrera Jimenez, Miguel; Abu-El-Rub, Noor; Morris, Michele; Moal, Bertrand; Verdy, Guillaume; Cho, Kelly; Ho, Yuk-Lam; Patel, Lav P; Dagliati, Arianna; Neuraz, Antoine; Klann, Jeffrey G; South, Andrew M; Visweswaran, Shyam; Hanauer, David A; Maidlow, Sarah E; Liu, Mei; Mowery, Danielle L; Batugo, Ashley; Makoudjou, Adeline; Tippmann, Patric; Zöller, Daniela; Brat, Gabriel A; Luo, Yuan; Avillach, Paul; Bellazzi, Riccardo; Chiovato, Luca; Malovini, Alberto; Tibollo, Valentina; Samayamuthu, Malarkodi Jebathilagam; Serrano Balazote, Pablo; Xia, Zongqi; Loh, Ne Hooi Will; Chiudinelli, Lorenzo; Bonzel, Clara-Lea; Hong, Chuan; Zhang, Harrison G; Weber, Griffin M; Kohane, Isaac S; Cai, Tianxi; Omenn, Gilbert S; Holmes, John H.
  • Tan BWL; Department of Medicine, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228.
  • Tan BWQ; Department of Medicine, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228.
  • Tan ALM; Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA.
  • Schriver ER; Data Analytics Center, University of Pennsylvania Health System, 3600 Civic Center Boulevard, Philadelphia, PA 19104, USA.
  • Gutiérrez-Sacristán A; Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA.
  • Das P; Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA.
  • Yuan W; Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA.
  • Hutch MR; Department of Preventive Medicine, Northwestern University, 750 North Lake Shore Drive, Chicago, IL 60611, USA.
  • García Barrio N; Department of Health Informatics, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n 28041 Madrid, Spain.
  • Pedrera Jimenez M; Department of Health Informatics, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n 28041 Madrid, Spain.
  • Abu-El-Rub N; Department of Internal Medicine, Division of Medical Informatics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
  • Morris M; Department of Biomedical Informatics, University of Pittsburgh, 5607 Baum Blvd, Pittsburgh, PA 15206, USA.
  • Moal B; IAM Unit, Bordeaux University Hospital, Place Amélie Rabat Léon, 33076 Bordeaux, France.
  • Verdy G; IAM Unit, Bordeaux University Hospital, Place Amélie Rabat Léon, 33076 Bordeaux, France.
  • Cho K; Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, 2 Avenue De Lafayette, Boston, MA 02130, USA.
  • Ho YL; Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, 2 Avenue De Lafayette, Boston, MA 02130, USA.
  • Patel LP; Department of Internal Medicine, Division of Medical Informatics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
  • Dagliati A; Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Italy, Via Ferrata 5, 27100 Pavia, Italy.
  • Neuraz A; Department of Biomedical Informatics, Hôpital Necker-Enfants Malade, Assistance Publique Hôpitaux de Paris, University of Paris, 149 Rue de Sèvres, 75015 Paris, France.
  • Klann JG; Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
  • South AM; Department of Pediatrics-Section of Nephrology, Brenner Children's Hospital, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157, USA.
  • Visweswaran S; Department of Biomedical Informatics, University of Pittsburgh, 5607 Baum Blvd, Pittsburgh, PA 15206, USA.
  • Hanauer DA; Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA, 100-107 NCRC, 2800 Plymouth Road, Ann Arbor, MI 48109, USA.
  • Maidlow SE; Michigan Institute for Clinical and Health Research (MICHR) Informatics, University of Michigan, NCRC Bldg 400, 2800 Plymouth Road, Ann Arbor, MI, United States.
  • Liu M; Department of Internal Medicine, Division of Medical Informatics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
  • Mowery DL; Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, 3700 Hamilton Walk, Richards Hall, A202, Philadelphia, PA 19104, USA.
  • Batugo A; Institute for Biomedical Informatics, University of Pennsylvania Perelman School of Medicine, 401 Blockley Hall 423 Guardian Drive Philadelphia, PA 19104, USA.
  • Makoudjou A; Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Zinkmattenstraße 6a, DE79108 Freiburg, Germany.
  • Tippmann P; Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Zinkmattenstraße 6a, DE79108 Freiburg, Germany.
  • Zöller D; Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Zinkmattenstraße 6a, DE79108 Freiburg, Germany.
  • Brat GA; Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA.
  • Luo Y; Department of Preventive Medicine, Northwestern University, 750 North Lake Shore Drive, Chicago, IL 60611, USA.
  • Avillach P; Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA.
  • Bellazzi R; Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Italy, Via Ferrata 5, 27100 Pavia, Italy.
  • Chiovato L; Unit of Internal Medicine and Endocrinology, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Via Maugeri 4, 27100 Pavia, Italy.
  • Malovini A; Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy., Via Maugeri 4, 27100 Pavia, Italy.
  • Tibollo V; Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy., Via Maugeri 4, 27100 Pavia, Italy.
  • Samayamuthu MJ; Department of Biomedical Informatics, University of Pittsburgh, 5607 Baum Blvd, Pittsburgh, PA 15206, USA.
  • Serrano Balazote P; Department of Health Informatics, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n 28041 Madrid, Spain.
  • Xia Z; Department of Neurology, University of Pittsburgh, 3501 5th Avenue, BST-3 Suite 7014, Pittsburgh, PA 15260, USA.
  • Loh NHW; Department of Anaesthesia, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074.
  • Chiudinelli L; UOC Ricerca, Innovazione e Brand reputation, ASST Papa Giovanni XXIII, Bergamo, P.zza OMS 1 - 24127 Bergamo, Italy.
  • Bonzel CL; Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA.
  • Hong C; Department of Biostatistics and Bioinformatics, Duke University, 2424 Erwin Road, Durham, NC, United States.
  • Zhang HG; Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA.
  • Weber GM; Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA.
  • Kohane IS; Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA.
  • Cai T; Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA.
  • Omenn GS; Department of Biomedical Informatics, Harvard Medical School, 10 Shattuck Street, Boston, MA 02115, USA.
  • Holmes JH; Department of Computational Medicine & Bioinformatics, University of Michigan, 2017B Palmer Commons, 100 Washtenaw, Ann Arbor, MI 48109-2218.
EClinicalMedicine ; 55: 101724, 2023 Jan.
Article in English | MEDLINE | ID: covidwho-2104824
ABSTRACT

Background:

While acute kidney injury (AKI) is a common complication in COVID-19, data on post-AKI kidney function recovery and the clinical factors associated with poor kidney function recovery is lacking.

Methods:

A retrospective multi-centre observational cohort study comprising 12,891 hospitalized patients aged 18 years or older with a diagnosis of SARS-CoV-2 infection confirmed by polymerase chain reaction from 1 January 2020 to 10 September 2020, and with at least one serum creatinine value 1-365 days prior to admission. Mortality and serum creatinine values were obtained up to 10 September 2021.

Findings:

Advanced age (HR 2.77, 95%CI 2.53-3.04, p < 0.0001), severe COVID-19 (HR 2.91, 95%CI 2.03-4.17, p < 0.0001), severe AKI (KDIGO stage 3 HR 4.22, 95%CI 3.55-5.00, p < 0.0001), and ischemic heart disease (HR 1.26, 95%CI 1.14-1.39, p < 0.0001) were associated with worse mortality outcomes. AKI severity (KDIGO stage 3 HR 0.41, 95%CI 0.37-0.46, p < 0.0001) was associated with worse kidney function recovery, whereas remdesivir use (HR 1.34, 95%CI 1.17-1.54, p < 0.0001) was associated with better kidney function recovery. In a subset of patients without chronic kidney disease, advanced age (HR 1.38, 95%CI 1.20-1.58, p < 0.0001), male sex (HR 1.67, 95%CI 1.45-1.93, p < 0.0001), severe AKI (KDIGO stage 3 HR 11.68, 95%CI 9.80-13.91, p < 0.0001), and hypertension (HR 1.22, 95%CI 1.10-1.36, p = 0.0002) were associated with post-AKI kidney function impairment. Furthermore, patients with COVID-19-associated AKI had significant and persistent elevations of baseline serum creatinine 125% or more at 180 days (RR 1.49, 95%CI 1.32-1.67) and 365 days (RR 1.54, 95%CI 1.21-1.96) compared to COVID-19 patients with no AKI.

Interpretation:

COVID-19-associated AKI was associated with higher mortality, and severe COVID-19-associated AKI was associated with worse long-term post-AKI kidney function recovery.

Funding:

Authors are supported by various funders, with full details stated in the acknowledgement section.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Language: English Journal: EClinicalMedicine Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Language: English Journal: EClinicalMedicine Year: 2023 Document Type: Article