AKI in Hospitalized Patients with COVID-19 and Seasonal Influenza: A Comparative Analysis. Kidney360 2021 Apr 29;2(4):619-628
Date
02/26/2021Pubmed ID
35373047Pubmed Central ID
PMC8791326DOI
10.34067/KID.0007322020Scopus ID
2-s2.0-85107688077 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) is often compared with seasonal influenza and the two diseases have similarities, including the risk of systemic manifestations such as AKI. The aim of this study was to perform a comparative analysis of the prevalence, risk factors, and outcomes of AKI in patients who were hospitalized with COVID-19 and influenza.
METHODS: Retrospective cohort study of patients who were hospitalized with COVID-19 (n=325) or seasonal influenza (n=433). AKI was defined by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Baseline characteristics and hospitalization data were collected, and multivariable analysis was performed to determine the independent predictors for AKI.
RESULTS: AKI occurred in 33% of COVID-19 hospitalizations (COV-AKI) and 33% of influenza hospitalizations (FLU-AKI). After adjusting for age, sex, and comorbidity count, the risk of stage 3 AKI was significantly higher in COV-AKI (OR, 3.46; 95% CI, 1.63 to 7.37). Pre-existing CKD was associated with a six- to seven-fold increased likelihood for FLU-AKI and COV-AKI. Mechanical ventilation was associated with a higher likelihood of developing AKI in the COVID-19 cohort (OR, 5.85; 95% CI, 2.30 to 15.63). Black race, after adjustment for comorbidities, was an independent risk for COV-AKI.
CONCLUSIONS: Pre-existing CKD was a major risk factor for AKI in both cohorts. Black race (independent of comorbidities) and mechanical ventilation were associated with a higher risk of developing COV-AKI, which is characterized by a higher burden of stage 3 AKI and overall poorer prognosis.
Author List
Bhasin B, Veitla V, Dawson AZ, Garacci Z, Sturgill D, Ozieh MN, Regner KRAuthors
Aprill Z. Dawson PhD, MPH Assistant Professor in the Medicine department at Medical College of WisconsinMukoso Nwamaka Ozieh MD Associate Professor in the Medicine department at Medical College of Wisconsin
Kevin R. Regner MD Interim Chair, Professor in the Medicine department at Medical College of Wisconsin
Vineet Veitla MD Assistant Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Acute Kidney InjuryHospital Mortality
Humans
Influenza, Human
Retrospective Studies
Seasons