Clinical Features and Outcomes of Acute Kidney Injury in Patients Infected with COVID-19 in Xiangyang, China

Blood Purif. 2021;50(4-5):513-519. doi: 10.1159/000513163. Epub 2020 Dec 14.

Abstract

Background: In December 2019, pneumonia associated with COVID-19 has spread from Wuhan to other areas in China. In the present study, we aimed to further clarify the clinical features and outcomes of acute kidney injury (AKI) in patients infected with COVID-19 in Xiangyang, Hubei, China.

Methods: All confirmed cases of COVID-19 with AKI in Xiangyang Central Hospital from January 22 to May 31, 2020, were included in this retrospective study. Data of epidemiological, clinical, laboratory, radiological tests, treatment, complication, and outcomes were collected and analyzed. Patients were divided into intensive care unit (ICU) group and isolation ward (non-ICU) group.

Results: Of the total patients, 33.3% in the non-ICU group and 85.7% in the ICU group had chronic diseases. In addition, 85.7% of patients in the ICU group died. The most common symptoms were fever, cough, and fatigue. The lymphocyte count in the ICU group was significantly reduced compared with the non-ICU group. The chest computed tomography (CT) images appeared showed multiple mottles and ground-glass opacity. Strip shadow could be found in chest CT images of some recovered patients. All patients received antiviral treatment. Most patients in the ICU group were given methylprednisolone, immunoglobulin, antibiotics, and mechanical ventilation and 35.7% of patients in the ICU group received continuous renal replacement therapy.

Conclusions: Elderly with chronic comorbidities were more susceptible to COVID-19, showing a higher mortality rate due to multiple organ damage, and 35.7% of patients with AKI in ICU received renal replacement therapy. Moreover, part of the cured patients might need additional time to recover for poor lung function.

Keywords: Acute kidney injury; Clinical features; Coronavirus disease 2019; Multiple organ damage; Renal replacement therapy.

MeSH terms

  • Acute Kidney Injury / epidemiology*
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / therapy
  • Adult
  • Aged
  • Antiviral Agents / therapeutic use
  • COVID-19 / blood
  • COVID-19 / complications*
  • COVID-19 / diagnostic imaging
  • COVID-19 / therapy
  • COVID-19 Drug Treatment
  • COVID-19 Serotherapy
  • Cardiovascular Agents / therapeutic use
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / epidemiology
  • China / epidemiology
  • Chronic Disease / mortality
  • Comorbidity
  • Female
  • Hospital Mortality*
  • Hospitals, Urban / statistics & numerical data
  • Humans
  • Immunization, Passive
  • Intensive Care Units / statistics & numerical data
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / mortality
  • Plasma Exchange / methods
  • Plasma Exchange / statistics & numerical data
  • Renal Dialysis / methods
  • Renal Dialysis / statistics & numerical data
  • Renal Insufficiency, Chronic / complications
  • Respiration, Artificial / adverse effects
  • Respiration, Artificial / statistics & numerical data
  • Retrospective Studies
  • SARS-CoV-2*
  • Symptom Assessment
  • Tomography, X-Ray Computed

Substances

  • Antiviral Agents
  • Cardiovascular Agents