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Background Some patients with COVID-19 pneumonia also present with kidney injury, and autopsy findings of patients who died from the illness sometimes show renal damage. However, little is known about the clinical characteristics of kidneyrelated complications, including hematuria, proteinuria, and AKI.Methods In this retrospective, single-center study in China, we analyzed data from electronic medical records of 333 hospitalized patients with COVID-19 pneumonia, including information about clinical, laboratory, radiologic, and other characteristics, as well as information about renal outcomes. ResultsWe found that 251 of the 333 patients (75.4%) had abnormal urine dipstick tests or AKI. Of 198 patients with renal involvement for the median duration of 12 days, 118 (59.6%) experienced remission of pneumonia during this period, and 111 of 162 (68.5%) patients experienced remission of proteinuria. Among 35 patients who developed AKI (with AKI identified by criteria expanded somewhat beyond the 2012 Kidney Disease: Improving Global Outcomes definition), 16 (45.7%) experienced complete recovery of kidney function. We suspect that most AKI cases were intrinsic AKI. Patients with renal involvement had higher overall mortality compared with those without renal involvement (28 of 251 [11.2%] versus one of 82 [1.2%], respectively). Stepwise multivariate binary logistic regression analyses showed that severity of pneumonia was the risk factor most commonly associated with lower odds of proteinuric or hematuric remission and recovery from AKI.Conclusions Renal abnormalities occurred in the majority of patients with COVID-19 pneumonia. Although proteinuria, hematuria, and AKI often resolved in such patients within 3 weeks after the onset of symptoms, renal complications in COVID-19 were associated with higher mortality.

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.