Previous studies have indicated an association between coronavirus disease 2019 (COVID-19) and acute kidney injury (AKI) but lacked a control group. The prospective observational COronaVIrus-surviVAl (COVIVA) study performed at the University Hospital, Basel, Switzerland consecutively enrolled patients with symptoms suggestive of COVID-19. We compared patients who tested positive for SARS-CoV-2 with patients who tested negative but with an adjudicated diagnosis of a respiratory tract infection, including pneumonia. The primary outcome measure was death at 30 days, and the secondary outcomes were AKI incidence and a composite endpoint of death, intensive care treatment or rehospitalization at 30 days. Five hundred and seven patients were diagnosed with respiratory tract infections, and of those, 183 (36%) had a positive PCR swab test for SARS-CoV-2. The incidence of AKI was higher in patients with COVID-19 (30% versus 12%, p < 0.001), more severe (KDIGO stage 3, 22% versus 13%, p = 0.009) and more often required renal replacement therapy (4.4% versus 0.93%; p = 0.03). The risk of 30-day mortality and a composite endpoint was higher in patients with COVID-19-associated AKI (adjusted hazard ratio (aHR) mortality 3.98, 95% confidence interval (CI) 1.10–14.46, p = 0.036; composite endpoint aHR 1.84, 95% CI 1.02–3.31, p = 0.042). The mortality risk was attenuated when adjusting for disease severity (aHR 3.60, 95% CI 0.93–13.96, p = 0.062). AKI occurs more frequently and with a higher severity in patients with COVID-19 and is associated with worse outcomes.
【저자키워드】 COVID-19, SARS-CoV-2, Mortality, Pneumonia, respiratory tract infection, Acute kidney injury, 【초록키워드】 coronavirus disease, severity, disease severity, Diagnosis, risk, Symptom, Respiratory tract infections, outcomes, AKI, Patient, death, incidence, Swab test, university, Switzerland, association, 30-Day mortality, renal replacement therapy, mortality risk, composite endpoint, control group, 95% CI, 95% confidence interval, adjusted hazard ratio, intensive care treatment, primary outcome measure, secondary outcome, Basel, previous study, positive, positive PCR, KDIGO, rehospitalization, Seven, enrolled, tested, performed, indicated, diagnosed, required, occur, patients with COVID-19, 【제목키워드】 Prospective, respiratory, Other, with COVID-19,