Acute Kidney Injury Is Associated With In-hospital Mortality in Older Patients With COVID-19

Abstract

Background The epidemic of COVID-19 presents a special threat to elderly adults. However, information on kidney damage in elderly patients with COVID-19 is limited. Acute kidney injury (AKI) is common in hospitalized adults and associated with a poor prognosis. We sought to explore the association between AKI and mortality in elderly patients with COVID-19. Methods We conducted a retrospective, observational cohort study in a large tertiary-care university hospital in Wuhan, China. All consecutive inpatients elderly than 65 years with COVID-19 were enrolled in this cohort. Demographic data, laboratory values, comorbidities, treatments, and clinical outcomes were all collected. Data were compared between patients with AKI and without AKI. The association between AKI and mortality was analyzed. Results Of 1764 in-hospital patients, 882 elderly cases were included in this cohort. The median age was 71 years (interquartile range [IQR]: 68-77), 440 (49.9%) were man. The most presented comorbidity was cardiovascular diseases (58.2%), followed by diabetes (31.4%). Of 882 elderly patients, 115 (13%) developed AKI and 128 (14.5%) died. Patients with AKI had higher mortality than those without AKI (68 [59.1%] vs 60 [7.8%]; P < 0.001). Multivariable Cox regression analysis showed that increasing odds of in-hospital mortality associated with higher interleukin-6 on admission, myocardial injury and AKI. Conclusion AKI is not an uncommon complication in elderly patients with COVID-19 but is associated with high risk of death. Physicians should aware the risk of AKI in elderly patients with COVID-19.

Clinical Characteristics and Risk Factors for Mortality in Very Old Patients Hospitalized With COVID-19 in Spain

“…Acute kidney injury, a common complication in hospitalized adults, is associated with poor prognosis. It has recently been related to higher mortality in patients ≥ 65 years old with COVID-19 ( 40 ), a finding that was also observed in our study.…”

Risk Factors for Acute Kidney Injury in Patients with Coronavirus Disease 2019 (COVID-19): A Meta-Analysis

“…Finally, 11 studies (6, 9-18) with 8815 patients with COVID-19 ful lled eligibility criteria (Fig 1). Table 1 presents the summary characteristics of the 11 included studies [6,[9][10][11][12][13][14][15][16][17][18]. The prevalence of AKI ranged from 10.3% to 81%.…”

“…The prevalence of AKI ranged from 10.3% to 81%. Ten studies [6,[9][10][11][12][13][14][16][17][18] were single center, and one [15] was multicenter.…”

“…Eight studies [6, 9-13, 15, 17] used retrospective cohorts, two [14,18] were observational studies, and one [16] was a cohort trial. Studies were conducted in China [9,10,13,15], United States [6,11,17,18], France [12,16], and Australia [14]. We assessed the risk of bias of the studies included in the qualitative review based on Newcastle-Ottawa Scale criteria.…”

Elevated interleukin-6 and adverse outcomes in COVID-19 patients: a meta-analysis based on adjusted effect estimates

“…After assessing the full text, 176 were excluded because they did not report the association between IL-6 level and poor outcomes in COVID-19 patients, and 51 were excluded because original data were not reported or adjusted effect was not used. Finally, 16 articles consisting of 8752 COVID-19 patients were included in the meta-analysis (Ayanian et al 2020 ; Bellmann-Weiler et al 2020 ; Cummings et al 2020 ; Del Valle et al 2020 ; Li et al 2020 ; Liu et al 2020a , b , c , d , e ; Phipps et al 2020 ; Sardu et al 2020 ; Song et al 2020 ; Tian et al 2020 ; Wang et al 2020 ; Yan et al 2020 ). The characteristics of the 16 eligible studies are shown in Table 1 .…”