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Background: Information on kidney impairment in patients with coronavirus disease 2019 is limited. This study aims to assess the prevalence and impact of abnormal urine analysis and kidney dysfunction in hospitalized COVID-19 patients in Wuhan. Methods:We conducted a consecutive cohort study of COVID-19 patients admitted in a tertiary teaching hospital with 3 branches following a major outbreak in Wuhan in 2020. Hematuria, proteinuria, serum creatinine concentration and other clinical parameters were extracted from the electronic hospitalization databases and laboratory databases. Incidence rate for acute kidney injury (AKI) was examined during the study period. Association between kidney impairment and in-hospital death was analyzed. Results:We included 710 consecutive COVID-19 patients, 89 (12.3%) of whom died in hospital. The median age of the patients was 63 years (inter quartile range, 51-71), including 374 men and 336 women. On admission, 44% of patients have proteinuria hematuria and 26.9% have hematuria, and the prevalence of elevated serum creatinine and blood urea nitrogen were 15.5% and 14.1% respectively. During the study period, AKI occurred in 3.2% patients. Kaplan-Meier analysis demonstrated that patients with kidney impairment have higher risk for in-hospital death. Cox proportional hazard regression confirmed that elevated serum creatinine, elevated urea nitrogen, AKI, proteinuria and hematuria was an independent risk factor for in-hospital death after adjusting for age, sex, disease severity, leukocyte count and lymphocyte count. : medRxiv preprint Conclusions: The prevalence of kidney impairment (hematuria, proteinuria and kidney dysfunction) in hospitalized COVID-19 patients was high. After adjustment for confounders, kidney impairment indicators were associated with higher risk of inhospital death. Clinicians should increase their awareness of kidney impairment in hospitalized COVID-19 patients. Wu, M.; Guo, J.; Yao, J.; Liao, X.; Song, S.; Han, M.; Li, J.; Duan, G.; Zhou, Y.; Wu, X.; Zhou, Z.; Wang, T.; Hu, M.; Chen, X.; Fu, Y.; Lei, C.; Dong, H.; Zhou, Y.; Jia, H.; Chen, X.; Yan, J., Caution on Kidney Dysfunctions of 2019-nCoV Patients. 2020 23. Kumar, A.; Zarychanski, R.; Pinto, R.; Cook, D. J.; Marshall, J.; Lacroix, J.; Stelfox, T.; Bagshaw, S.; Choong, K.; Lamontagne, F.; Turgeon, A. F.; Lapinsky, S.; Ahern, S. P.; Smith, O.; Siddiqui, F.; Jouvet, P.; Khwaja, K.; McIntyre, L.; Menon, K.; Hutchison, J.; Hornstein, D.; Joffe, A.; Lauzier, F.; Singh, J.; Karachi, T.; Wiebe, K.; Olafson, K.; Ramsey, C.; Sharma, S.; Dodek, P.; Meade, M.; Hall, R.; Fowler, R. A.; Canadian Critical Care Trials Group, H. N. C., Critically ill patients with 2009 influenza A(H1N1) infection in Canada.

Background and objectivesSince December 2019, coronavirus disease 2019 (COVID-19) outbreak occurred and has rapidly spread worldwide. However, little information is available about the AKI in COVID-19. We aimed to evaluate the incidence, risk factors, and prognosis of AKI in adult patients with COVID-19.Design, setting, participants, & measurementsThis was a retrospective cohort study of 1392 patients with COVID-19 admitted to a tertiary teaching hospital. Clinical characteristics and laboratory data were extracted from electronic hospitalization and laboratory databases. AKI was defined and staged according to the 2012 Kidney Disease: Improving Global Outcomes criteria. Risk factors for AKI and the association of AKI with in-hospital mortality were assessed.ResultsA total of 7% (99 of 1392) of patients developed AKI during hospitalization, 40% (40 of 99) of which occurred within 1 week of admission. Factors associated with a higher risk of AKI include severe disease (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.37 to 3.67), higher baseline serum creatinine (OR, 2.19; 95% CI, 1.17 to 4.11), lymphopenia (OR, 1.99; 95% CI, 1.12 to 3.53), and elevated D-dimer level (OR, 2.68; 95% CI, 1.07 to 6.70). The in-hospital mortality in patients with AKI stage 1, stage 2, and stage 3 was 62%, 77%, and 80%, respectively. AKI was associated with in-hospital mortality even after adjustment for confounders (OR, 5.12; 95% CI, 2.70 to 9.72).ConclusionsAKI is uncommon but carries high in-hospital mortality in patients with COVID-19.