Mortality and evolution between community and hospital-acquired COVID-AKI

<h4>Background</h4> Acute kidney injury (AKI) is associated with poor outcomes in COVID patients. Differences between hospital-acquired (HA-AKI) and community-acquired AKI (CA-AKI) are not well established. <h4>Methods</h4> Prospective, observational cohort study. We included...

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Autores principales:	Jonathan S. Chávez-Íñiguez, José H. Cano-Cervantes, Pablo Maggiani-Aguilera, Natashia Lavelle-Góngora, Josué Marcial-Meza, Estefanía P. Camacho-Murillo, Cynthia Moreno-González, Jarumi A. Tanaka-Gutiérrez, Ana P. Villa Zaragoza, Karla E. Rincón-Souza, Sandra Muñoz-López, Olivia Montoya-Montoya, Guillermo Navarro-Blackaller, Aczel Sánchez-Cedillo, Luis E. Morales-Buenrostro, Guillermo García-García
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a915627a60f648929bf4ec5b05b6fa7a
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spelling	oai:doaj.org-article:a915627a60f648929bf4ec5b05b6fa7a2021-11-11T07:14:41ZMortality and evolution between community and hospital-acquired COVID-AKI1932-6203https://doaj.org/article/a915627a60f648929bf4ec5b05b6fa7a2021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568145/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> Acute kidney injury (AKI) is associated with poor outcomes in COVID patients. Differences between hospital-acquired (HA-AKI) and community-acquired AKI (CA-AKI) are not well established. <h4>Methods</h4> Prospective, observational cohort study. We included 877 patients hospitalized with COVID diagnosis at two third-level hospitals in Mexico. Primary outcome was all-cause mortality at 28 days compared between COVID patients with CA-AKI and HA-AKI. Secondary outcomes included the need for KRT, and risk factors associated with the development of CA-AKI and HA-AKI. <h4>Results</h4> A total of 377 patients (33.7%) developed AKI. CA-AKI occurred in 202 patients (59.9%) and HA-AKI occurred in 135 (40.1%). Patients with CA-AKI had more significant comorbidities, including diabetes (52.4% vs 38.5%), hypertension (58.4% vs 39.2%), CKD (30.1% vs 14.8%), and COPD (5.9% vs 1.4%), than those with HA-AKI. Patients’ survival without AKI was 87.1%, with CA-AKI it was 75.4%, and with HA-AKI it was 69.6%, log-rank test p < 0.001. Only age > 60 years (OR 1.12, 95% CI 1.06–1.18, p <0.001), COVID severity (OR 1.09, 95% CI 1.03–1.16, p = 0.002), the need in mechanical lung ventilation (OR 1.67, 95% CI 1.56–1.78, p <0.001), and HA-AKI stage 3 (OR 1.16, 95% CI 1.05–1.29, p = 0.003) had a significant increase in mortality. The presence of CKD (OR 1.48, 95% CI 1.391.56, p < 0.001), serum lymphocytes < 1000 μL (OR 1.03, 95% CI 1.00–1.07, p = 0.03), the need in mechanical lung ventilation (OR 1.06, 95% CI 1.02–1.11, p = 0.003), and CA-AKI stage 3 (OR 1.37, 95% CI 1.29–1.46, p < 0.001) were the only variables associated with a KRT start. <h4>Conclusions</h4> We found that COVID patients who are complicated by CA-AKI have more comorbidities and worse biochemical parameters at the time of hospitalization than HA-AKI patients, but despite these differences, their probability of dying is similar.Jonathan S. Chávez-ÍñiguezJosé H. Cano-CervantesPablo Maggiani-AguileraNatashia Lavelle-GóngoraJosué Marcial-MezaEstefanía P. Camacho-MurilloCynthia Moreno-GonzálezJarumi A. Tanaka-GutiérrezAna P. Villa ZaragozaKarla E. Rincón-SouzaSandra Muñoz-LópezOlivia Montoya-MontoyaGuillermo Navarro-BlackallerAczel Sánchez-CedilloLuis E. Morales-BuenrostroGuillermo García-GarcíaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jonathan S. Chávez-Íñiguez José H. Cano-Cervantes Pablo Maggiani-Aguilera Natashia Lavelle-Góngora Josué Marcial-Meza Estefanía P. Camacho-Murillo Cynthia Moreno-González Jarumi A. Tanaka-Gutiérrez Ana P. Villa Zaragoza Karla E. Rincón-Souza Sandra Muñoz-López Olivia Montoya-Montoya Guillermo Navarro-Blackaller Aczel Sánchez-Cedillo Luis E. Morales-Buenrostro Guillermo García-García Mortality and evolution between community and hospital-acquired COVID-AKI
description	<h4>Background</h4> Acute kidney injury (AKI) is associated with poor outcomes in COVID patients. Differences between hospital-acquired (HA-AKI) and community-acquired AKI (CA-AKI) are not well established. <h4>Methods</h4> Prospective, observational cohort study. We included 877 patients hospitalized with COVID diagnosis at two third-level hospitals in Mexico. Primary outcome was all-cause mortality at 28 days compared between COVID patients with CA-AKI and HA-AKI. Secondary outcomes included the need for KRT, and risk factors associated with the development of CA-AKI and HA-AKI. <h4>Results</h4> A total of 377 patients (33.7%) developed AKI. CA-AKI occurred in 202 patients (59.9%) and HA-AKI occurred in 135 (40.1%). Patients with CA-AKI had more significant comorbidities, including diabetes (52.4% vs 38.5%), hypertension (58.4% vs 39.2%), CKD (30.1% vs 14.8%), and COPD (5.9% vs 1.4%), than those with HA-AKI. Patients’ survival without AKI was 87.1%, with CA-AKI it was 75.4%, and with HA-AKI it was 69.6%, log-rank test p < 0.001. Only age > 60 years (OR 1.12, 95% CI 1.06–1.18, p <0.001), COVID severity (OR 1.09, 95% CI 1.03–1.16, p = 0.002), the need in mechanical lung ventilation (OR 1.67, 95% CI 1.56–1.78, p <0.001), and HA-AKI stage 3 (OR 1.16, 95% CI 1.05–1.29, p = 0.003) had a significant increase in mortality. The presence of CKD (OR 1.48, 95% CI 1.391.56, p < 0.001), serum lymphocytes < 1000 μL (OR 1.03, 95% CI 1.00–1.07, p = 0.03), the need in mechanical lung ventilation (OR 1.06, 95% CI 1.02–1.11, p = 0.003), and CA-AKI stage 3 (OR 1.37, 95% CI 1.29–1.46, p < 0.001) were the only variables associated with a KRT start. <h4>Conclusions</h4> We found that COVID patients who are complicated by CA-AKI have more comorbidities and worse biochemical parameters at the time of hospitalization than HA-AKI patients, but despite these differences, their probability of dying is similar.
format	article
author	Jonathan S. Chávez-Íñiguez José H. Cano-Cervantes Pablo Maggiani-Aguilera Natashia Lavelle-Góngora Josué Marcial-Meza Estefanía P. Camacho-Murillo Cynthia Moreno-González Jarumi A. Tanaka-Gutiérrez Ana P. Villa Zaragoza Karla E. Rincón-Souza Sandra Muñoz-López Olivia Montoya-Montoya Guillermo Navarro-Blackaller Aczel Sánchez-Cedillo Luis E. Morales-Buenrostro Guillermo García-García
author_facet	Jonathan S. Chávez-Íñiguez José H. Cano-Cervantes Pablo Maggiani-Aguilera Natashia Lavelle-Góngora Josué Marcial-Meza Estefanía P. Camacho-Murillo Cynthia Moreno-González Jarumi A. Tanaka-Gutiérrez Ana P. Villa Zaragoza Karla E. Rincón-Souza Sandra Muñoz-López Olivia Montoya-Montoya Guillermo Navarro-Blackaller Aczel Sánchez-Cedillo Luis E. Morales-Buenrostro Guillermo García-García
author_sort	Jonathan S. Chávez-Íñiguez
title	Mortality and evolution between community and hospital-acquired COVID-AKI
title_short	Mortality and evolution between community and hospital-acquired COVID-AKI
title_full	Mortality and evolution between community and hospital-acquired COVID-AKI
title_fullStr	Mortality and evolution between community and hospital-acquired COVID-AKI
title_full_unstemmed	Mortality and evolution between community and hospital-acquired COVID-AKI
title_sort	mortality and evolution between community and hospital-acquired covid-aki
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/a915627a60f648929bf4ec5b05b6fa7a
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Mortality and evolution between community and hospital-acquired COVID-AKI

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