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Coronaviruses

Editor-in-Chief

ISSN (Print): 2666-7967
ISSN (Online): 2666-7975

Research Article

Investigating the Relationship between COVID-19 In-hospital Death and Acute Kidney Injury

Author(s): Ramin Haghighi, Nikoo Fereyduny, Mohammad Bagher Oghazian, Ashkan Haghighi, Amir Bigdeli* and Amirhossein Sahebkar*

Volume 5, Issue 4, 2024

Published on: 29 January, 2024

Article ID: e290124226454 Pages: 8

DOI: 10.2174/0126667975284268240109110622

Price: $65

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Abstract

Introduction: Coronavirus Disease 2019 (COVID-19) can induce multiorgan failure, including acute kidney injury (AKI), which is associated with a poor prognosis. Some of these patients develop proteinuria, hematuria, and elevated serum creatinine, therefore some require hemodialysis. This study aimed to investigate the association between in-hospital death due to COVID-19 and the prevalence of AKI.

Methods: In a retrospective study, the available data of patients who died because of COVID-19 from April 1 to September 22, 2020 in a referral hospital was investigated using the case census method.

Results: A total of 190 patients who died of COVID-19 were evaluated. Of these, 111 (58.42%) had AKI, with 108 (56.84%) being male. The mean age of the subjects was 66.16±15.43 years old. The mean time from hospital admission to death was about 9 days in all patients. Although not statistically significant, the findings showed that patients who developed AKI died sooner. The most frequent underlying diseases were hypertension [n= 101 (53.16%)] and diabetes [n= 44 (23.16%)]. Moreover, a higher proportion of subjects with AKI as compared to those without AKI were admitted to the intensive care unit (ICU), and had abnormal proteinuria profile (p-value=0.045 and 0.025, respectively).

Conclusion: The prevalence of AKI was 58.42% in patients who died from COVID-19 disease. Moreover, abnormal proteinuria and ICU admission were significantly higher in COVID-19 patients with AKI than in those without AKI.

Keywords: Acute kidney injury, COVID-19, mortality, proteinuria, hematuria.

Graphical Abstract
[1]
Chávez-Valencia V, Orizaga-de-la-Cruz C, Lagunas-Rangel FA. Acute kidney injury in COVID-19 patients: Pathogenesis, clinical characteristics, therapy, and mortality. Diseases 2022; 10(3): 53.
[http://dx.doi.org/10.3390/diseases10030053] [PMID: 35997358]
[2]
Montezano AC, Camargo LL, Mary S, et al. SARS-CoV-2 spike protein induces endothelial inflammation via ACE2 independently of viral replication. Sci Rep 2023; 13(1): 14086.
[http://dx.doi.org/10.1038/s41598-023-41115-3] [PMID: 37640791]
[3]
Monpara JD, Sodha SJ, Gupta PK. COVID-19 associated complications and potential therapeutic targets. Eur J Pharmacol 2020; 886: 173548.
[http://dx.doi.org/10.1016/j.ejphar.2020.173548] [PMID: 32926918]
[4]
Choudhury A, Das NC, Patra R, Mukherjee S. In silico analyses on the comparative sensing of SARS-;CoV-;2 mRNA by the intracellular TLRs of humans. J Med Virol 2021; 93(4): 2476-86.
[http://dx.doi.org/10.1002/jmv.26776] [PMID: 33404091]
[5]
Mukherjee S, Huda S, Sinha Babu SP. Toll-;like receptor polymorphism in host immune response to infectious diseases: A review. Scand J Immunol 2019; 90(1): e12771.
[http://dx.doi.org/10.1111/sji.12771] [PMID: 31054156]
[6]
Choudhury A, Mukherjee S. In silico studies on the comparative characterization of the interactions of SARS-;CoV-;2 spike glycoprotein with ACE-;2 receptor homologs and human TLRs. J Med Virol 2020; 92(10): 2105-13.
[http://dx.doi.org/10.1002/jmv.25987] [PMID: 32383269]
[7]
Patra R, Chandra Das N, Mukherjee S. Targeting human TLRs to combat COVID-;19: A solution? J Med Virol 2021; 93(2): 615-7.
[http://dx.doi.org/10.1002/jmv.26387] [PMID: 32749702]
[8]
Nadim MK, Forni LG, Mehta RL, et al. COVID-19-associated acute kidney injury: Consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup. Nat Rev Nephrol 2020; 16(12): 747-64.
[http://dx.doi.org/10.1038/s41581-020-00356-5] [PMID: 33060844]
[9]
Legrand M, Bell S, Forni L, et al. Pathophysiology of COVID-19-associated acute kidney injury. Nat Rev Nephrol 2021; 17(11): 751-64.
[http://dx.doi.org/10.1038/s41581-021-00452-0] [PMID: 34226718]
[10]
McAdams M, Ostrosky-Frid M, Rajora N, Hedayati S. Effect of COVID-19 on kidney disease incidence and management. Kidney360 2021; 2(1): 141-53.
[http://dx.doi.org/10.34067/KID.0006362020] [PMID: 35368812]
[11]
Zheng X, Zhao Y, Yang L. Acute kidney injury in COVID-19: The chinese experience. Semin Nephrol 2020; 40(5): 430-42.
[http://dx.doi.org/10.1016/j.semnephrol.2020.09.001] [PMID: 33334457]
[12]
Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized With COVID-19 in the New York City Area. JAMA 2020; 323(20): 2052-9.
[http://dx.doi.org/10.1001/jama.2020.6775] [PMID: 32320003]
[13]
Fu EL, Janse RJ, de Jong Y, et al. Acute kidney injury and kidney replacement therapy in COVID-19: A systematic review and meta-analysis. Clin Kidney J 2020; 13(4): 550-63.
[http://dx.doi.org/10.1093/ckj/sfaa160] [PMID: 32897278]
[14]
Minami T, Iwata Y, Wada T. Renal complications in coronavirus disease 2019: A systematic review. Inflamm Regen 2020; 40(1): 31.
[http://dx.doi.org/10.1186/s41232-020-00140-9] [PMID: 33317643]
[15]
Argenziano MG, Bruce SL, Slater CL, et al. Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: Retrospective case series. BMJ 2020; 369: m1996.
[http://dx.doi.org/10.1136/bmj.m1996] [PMID: 32471884]
[16]
Hirsch JS, Ng JH, Ross DW, et al. Acute kidney injury in patients hospitalized with COVID-19. Kidney Int 2020; 98(1): 209-18.
[http://dx.doi.org/10.1016/j.kint.2020.05.006] [PMID: 32416116]
[17]
Ahmadian E, Hosseiniyan Khatibi SM, Razi Soofiyani S, et al. Covid-;19 and kidney injury: Pathophysiology and molecular mechanisms. Rev Med Virol 2021; 31(3): e2176.
[http://dx.doi.org/10.1002/rmv.2176] [PMID: 33022818]
[18]
Ejaz H, Alsrhani A, Zafar A, et al. COVID-19 and comorbidities: Deleterious impact on infected patients. J Infect Public Health 2020; 13(12): 1833-9.
[http://dx.doi.org/10.1016/j.jiph.2020.07.014] [PMID: 32788073]
[19]
Tarragon B, Valdenebro M, Serrano ML, Maroto A, Llopez-Carratala MR, Ramos A. Acute kidney failure in patients admitted due to COVID-19. Nefrologia 2021; 41(1): 34-40.
[20]
Li Z, Wu M, Yao J, Guo J, Liao X, Song S. Caution on kidney dysfunctions of COVID-19 patients. medRxiv 2020.2020.
[21]
Xiao G, Hu H, Wu F, et al. Acute kidney injury in patients hospitalized with COVID-19 in Wuhan, China: a single-center retrospective observational study. Nan Fang Yi Ke Da Xue Xue Bao 2021; 41(2): 157-63.
[PMID: 33624587]
[22]
Ng JH, Hirsch JS, Hazzan A, et al. Outcomes among patients hospitalized with COVID-19 and acute kidney injury. Am J Kidney Dis 2021; 77(2): 204-215.e1.
[http://dx.doi.org/10.1053/j.ajkd.2020.09.002] [PMID: 32961245]
[23]
Fisher M, Neugarten J, Bellin E, et al. AKI in hospitalized patients with and without COVID-19: A comparison study. J Am Soc Nephrol 2020; 31(9): 2145-57.
[http://dx.doi.org/10.1681/ASN.2020040509] [PMID: 32669322]
[24]
Chan L, Chaudhary K, Saha A, et al. AKI in hospitalized patients with COVID-19. J Am Soc Nephrol 2021; 32(1): 151-60.
[http://dx.doi.org/10.1681/ASN.2020050615] [PMID: 32883700]
[25]
Roushani J, Thomas D, Oliver MJ, et al. Acute kidney injury requiring renal replacement therapy in people with COVID-19 disease in Ontario, Canada: A prospective analysis of risk factors and outcomes. Clin Kidney J 2022; 15(3): 507-16.
[http://dx.doi.org/10.1093/ckj/sfab237] [PMID: 35198157]
[26]
Samaan F, Carneiro de Paula E, de Lima Souza FBG, et al. COVID-19-associated acute kidney injury patients treated with renal replacement therapy in the intensive care unit: A multicenter study in São Paulo, Brazil. PLoS One 2022; 17(1): e0261958.
[http://dx.doi.org/10.1371/journal.pone.0261958] [PMID: 35030179]
[27]
Elezkurtaj S, Greuel S, Ihlow J, et al. Causes of death and comorbidities in hospitalized patients with COVID-19. Sci Rep 2021; 11(1): 4263.
[http://dx.doi.org/10.1038/s41598-021-82862-5] [PMID: 33608563]
[28]
Bhaskaran K, Bacon S, Evans SJW, et al. Factors associated with deaths due to COVID-19 versus other causes: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform. Lancet Reg Health Eur 2021; 6: 100109.
[http://dx.doi.org/10.1016/j.lanepe.2021.100109] [PMID: 33997835]
[29]
Russell CD, Lone NI, Baillie JK. Comorbidities, multimorbidity and COVID-19. Nat Med 2023; 29(2): 334-43.
[http://dx.doi.org/10.1038/s41591-022-02156-9] [PMID: 36797482]
[30]
Ketcham SW, Bolig TC, Molling DJ, Sjoding MW, Flanders SA, Prescott HC. Causes and circumstances of death among patients hospitalized with COVID-19: A retrospective cohort study. Ann Am Thorac Soc 2021; 18(6): 1076-9.
[http://dx.doi.org/10.1513/AnnalsATS.202011-1381RL] [PMID: 33315531]
[31]
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
[http://dx.doi.org/10.1016/S0140-6736(20)30183-5] [PMID: 31986264]
[32]
WHO Coronavirus disease (COVID-19) pandemic. 2011. Available from: https://www.who.int/europe/emergencies/situations/covid-19#:~:text=Cases%20of%20novel%20coronavirus%20 [
[33]
Hao YJ, Wang YL, Wang MY, et al. The origins of COVID-;19 pandemic: A brief overview. Transbound Emerg Dis 2022; 69(6): 3181-97.
[http://dx.doi.org/10.1111/tbed.14732] [PMID: 36218169]
[34]
Guan W, Ni Z, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382(18): 1708-20.
[http://dx.doi.org/10.1056/NEJMoa2002032] [PMID: 32109013]
[35]
Woo PCY, Lau SKP, Huang Y, Yuen KY. Coronavirus diversity, phylogeny and interspecies jumping. Exp Biol Med 2009; 234(10): 1117-27.
[http://dx.doi.org/10.3181/0903-MR-94] [PMID: 19546349]
[36]
Vassilara F, Spyridaki A, Pothitos G, Deliveliotou A, Papadopoulos A. A rare case of human coronavirus 229e associated with acute respiratory distress syndrome in a healthy adult. Case Rep Infect Dis 2018; 2018: 1-4.
[http://dx.doi.org/10.1155/2018/6796839] [PMID: 29850307]
[37]
WHO. WHO Coronavirus (COVID-19) Dashboard https://covid19.who.int/
[38]
Baud D, Qi X, Nielsen-Saines K, Musso D, Pomar L, Favre G. Real estimates of mortality following COVID-19 infection. Lancet Infect Dis 2020; 20(7): 773.
[http://dx.doi.org/10.1016/S1473-3099(20)30195-X] [PMID: 32171390]
[39]
Makris K, Spanou L. Acute kidney injury: Definition, pathophysiology and clinical phenotypes. Clin Biochem Rev 2016; 37(2): 85-98.
[PMID: 28303073]
[40]
Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann EA, Goldstein SL. Kidney disease: Improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl 2012; 2(1): 1-138.
[41]
Batlle D, Soler MJ, Sparks MA, et al. Acute kidney injury in COVID-19: Emerging evidence of a distinct pathophysiology. J Am Soc Nephrol 2020; 31(7): 1380-3.
[http://dx.doi.org/10.1681/ASN.2020040419] [PMID: 32366514]
[42]
Pei G, Zhang Z, Peng J, et al. Renal involvement and early prognosis in patients with COVID-19 pneumonia. J Am Soc Nephrol 2020; 31(6): 1157-65.
[http://dx.doi.org/10.1681/ASN.2020030276] [PMID: 32345702]
[43]
Jialin X, Jing W, Xiaoqing Y, Shun X, Xue Z, Changjin L. Potential biochemical markers to identify severe cases among COVID-19 patients. medRxiv 2020; 2020; 20034447.2020; 03.19.20034447
[44]
Cheng Y, Luo R, Wang K, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int 2020; 97(5): 829-38.
[http://dx.doi.org/10.1016/j.kint.2020.03.005] [PMID: 32247631]
[45]
Zhou H, Zhang Z, Dobrinina M, et al. Urinalysis, but not blood biochemistry, detects the early renal impairment in patients with COVID-19. Diagnostics 2022; 12(3): 602.
[http://dx.doi.org/10.3390/diagnostics12030602] [PMID: 35328155]
[46]
Lotfi B, Farshid S, Dadashzadeh N, Valizadeh R, Rahimi MM. Is coronavirus disease 2019 (COVID-19) associated with renal involvement? A review of century infection. Jundishapur J Microbiol 2020; 13(4): e102899.
[47]
Enikeev D, Taratkin M, Efetov S, et al. Acute kidney injury in COVID-19: Are kidneys the target or just collateral damage? A comprehensive assessment of viral RNA and AKI rate in patients with COVID-19. Curr Opin Urol 2021; 31(4): 363-8.
[http://dx.doi.org/10.1097/MOU.0000000000000901] [PMID: 33989230]
[48]
Williamson EJ, Walker AJ, Bhaskaran K, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature 2020; 584(7821): 430-6.
[http://dx.doi.org/10.1038/s41586-020-2521-4] [PMID: 32640463]
[49]
Coomes EA, Haghbayan H. Interleukin-;6 in COVID-;19: A systematic review and meta-;analysis. Rev Med Virol 2020; 30(6): 1-9.
[http://dx.doi.org/10.1002/rmv.2141] [PMID: 32845568]
[50]
Barthélémy R, Beaucoté V, Bordier R, et al. Haemodynamic impact of positive end-expiratory pressure in SARS-CoV-2 acute respiratory distress syndrome: Oxygenation versus oxygen delivery. Br J Anaesth 2021; 126(2): e70-2.
[http://dx.doi.org/10.1016/j.bja.2020.10.026] [PMID: 33223045]
[51]
Welch HK, Kellum JA, Kane-Gill SL. Drug-;associated acute kidney injury identified in the united states food and drug administration adverse event reporting system database. Pharmacotherapy 2018; 38(8): 785-93.
[http://dx.doi.org/10.1002/phar.2152] [PMID: 29883524]

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