Gomez-Paz Sandra, Lam Eric, Gonzalez-Mosquera Luis, Cardenas-Maldonado Diana, Fogel Joshua, Gabrielle Kagan Ellen, Rubinstein Sofia
Division of Nephrology and Hypertension, Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, USA.
Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, USA.
J Crit Care Med (Targu Mures). 2022 May 12;8(2):80-88. doi: 10.2478/jccm-2022-0010. eCollection 2022 Apr.
Renal involvement in COVID-19 leads to severe disease and higher mortality. We study renal parameters in COVID-19 patients and their association with mortality and length of stay in hospital.
A retrospective study (n=340) of confirmed COVID-19 patients with renal involvement determined by the presence of acute kidney injury. Multivariate analyses of logistic regression for mortality and linear regression for length of stay (LOS) adjusted for relevant demographic, comorbidity, disease severity, and treatment covariates.
Mortality was 54.4% and mean LOS was 12.9 days. For mortality, creatinine peak (OR:35.27, 95% CI:2.81, 442.06, p<0.01) and persistent renal involvement at discharge (OR:4.47, 95% CI:1.99,10.06, p<0.001) were each significantly associated with increased odds for mortality. Increased blood urea nitrogen peak (OR:0.98, 95%CI:0.97,0.996, p<0.05) was significantly associated with decreased odds for mortality. For LOS, increased blood urea nitrogen peak (B:0.001, SE:<0.001, p<0.01), renal replacement therapy (B:0.19, SE:0.06, p<0.01), and increased days to acute kidney injury (B:0.19, SE:0.05, p<0.001) were each significantly associated with increased length of stay.
Our study emphasizes the importance in identifying renal involvement parameters in COVID-19 patients. These parameters are associated with LOS and mortality, and may assist clinicians to prognosticate COVID-19 patients with renal involvement.
新冠病毒病（COVID-19）的肾脏受累会导致病情严重且死亡率更高。我们研究了COVID-19患者的肾脏参数及其与死亡率和住院时间的关联。
对340例确诊的有肾脏受累（根据急性肾损伤的存在确定）的COVID-19患者进行回顾性研究。对死亡率进行逻辑回归多变量分析，对住院时间（LOS）进行线性回归分析，并对相关人口统计学、合并症、疾病严重程度和治疗协变量进行调整。
死亡率为54.4%，平均住院时间为12.9天。对于死亡率，肌酐峰值（比值比[OR]：35.27，95%置信区间[CI]：2.81，442.06，p<0.01）和出院时持续的肾脏受累（OR：4.47，95%CI：1.99，10.06，p<0.001）均与死亡率增加的几率显著相关。血尿素氮峰值增加（OR：0.98，95%CI：0.97，0.996，p<0.05）与死亡率降低的几率显著相关。对于住院时间，血尿素氮峰值增加（β：0.001，标准误[SE]：<0.001，p<0.01）、肾脏替代治疗（β：0.19，SE：0.06，p<0.01）以及急性肾损伤发生天数增加（β：0.19，SE：0.05，p<0.001）均与住院时间延长显著相关。
我们的研究强调了识别COVID-19患者肾脏受累参数的重要性。这些参数与住院时间和死亡率相关，可能有助于临床医生对有肾脏受累的COVID-19患者进行预后评估。
