Background Kidney disease and renal failure are associated with hospital deaths in patients with COVID − 19. We aimed to test if contrast enhancement affects short-term renal function in hospitalized COVID − 19 patients. Methods Plasma creatinine (P-creatinine) was measured on the day of computed tomography (CT) and 24 h, 48 h, and 4–10 days after CT. Contrast-enhanced ( n = 142) and unenhanced ( n = 24) groups were subdivided, based on estimated glomerular filtration rates (eGFR), > 60 and ≤ 60 ml/min/1.73 m 2 . Contrast-induced acute renal failure (CI-AKI) was defined as ≥27 μmol/L increase or a > 50% rise in P-creatinine from CT or initiation of renal replacement therapy during follow-up. Patients with renal replacement therapy were studied separately. We evaluated factors associated with a > 50% rise in P-creatinine at 48 h and at 4–10 days after contrast-enhanced CT. Results Median P-creatinine at 24–48 h and days 4–10 post-CT in patients with eGFR> 60 and eGFR≥30–60 in contrast-enhanced and unenhanced groups did not differ from basal values. CI-AKI was observed at 48 h and at 4–10 days post contrast administration in 24 and 36% ( n = 5/14) of patients with eGFR≥30–60. Corresponding figures in the eGFR> 60 contrast-enhanced CT group were 5 and 5% respectively, ( p < 0.037 and p < 0.001, Pearson χ 2 test). In the former group, four of the five patients died within 30 days. Odds ratio analysis showed that an eGFR≥30–60 and 30-day mortality were associated with CK-AKI both at 48 h and 4–10 days after contrast-enhanced CT. Conclusion Patients with COVID − 19 and eGFR≥30–60 had a high frequency of CK-AKI at 48 h and at 4–10 days after contrast administration, which was associated with increased 30-day mortality. For patients with eGFR≥30–60, we recommend strict indications are practiced for contrast-enhanced CT. Contrast-enhanced CT had a modest effect in patients with eGFR> 60.
【저자키워드】 Computed tomography, COVID − 19, Iodinated contrast, P-creatinine, Contrast-induced acute renal failure, 【초록키워드】 Hospitalized, hospital, renal function, COVID, Patient, death, Follow-up, group, disease, patients, glomerular filtration rate, 30-Day mortality, renal replacement therapy, administration, creatinine, Frequency, Analysis, acute renal failure, Factor, indication, renal, Pearson, Affect, FIVE, Result, was measured, defined, not differ, evaluated, patients died, 【제목키워드】 COVID-19, Hospitalized, renal function, contrast agent, negative, Effect, reduced, patients with moderate,