Risk factors associated with severity and mortality attributable to COVID-19 have been reported in different cohorts, highlighting the occurrence of acute kidney injury (AKI) in 25% of them. Among other, SARS-CoV-2 targets renal tubular cells and can cause acute renal damage. The aim of the present study was to evaluate the usefulness of urinary parameters in predicting intensive care unit (ICU) admission, mortality and development of AKI in hospitalized patients with COVID-19. Retrospective observational study, in a tertiary care hospital, between March 1st and April 19th, 2020. We recruited adult patients admitted consecutively and positive for SARS-CoV-2. Urinary and serum biomarkers were correlated with clinical outcomes (AKI, ICU admission, hospital discharge and in-hospital mortality) and evaluated using a logistic regression model and ROC curves. A total of 199 COVID-19 hospitalized patients were included. In AKI, the logistic regression model with a highest area under the curve (AUC) was reached by the combination of urine blood and previous chronic kidney disease, with an AUC of 0.676 (95%CI 0.512–0.840; p = 0.023); urine specific weight, sodium and albumin in serum, with an AUC of 0.837 (95% CI 0.766–0.909; p < 0.001) for ICU admission; and age, urine blood and lactate dehydrogenase levels in serum, with an AUC of 0.923 (95%CI 0.866–0.979; p < 0.001) for mortality prediction. For hospitalized patients with COVID-19, renal involvement and early alterations of urinary and serum parameters are useful as prognostic factors of AKI, the need for ICU admission and death.
【저자키워드】 Biomarkers, Risk factors, Biochemistry, Microbiology, Nephrology, Urology, 【초록키워드】 COVID-19, SARS-CoV-2, Risk factors, Mortality, intensive care, sodium, severity, hospital, intensive care unit, Acute kidney injury, Chronic kidney disease, hospitalized patients, lactate dehydrogenase, observational study, clinical outcomes, ICU, Clinical outcome, serum, AKI, Patient, albumin, ICU admission, death, Kidney disease, Prognostic factors, Urine, target, age, Admission, Care, in-hospital mortality, Blood, Lactate, Combination, AUC, Prognostic factor, renal damage, tubular cells, Renal involvement, Factor, specific weight, 95%CI, 95% CI, Adult patients, alteration, logistic regression model, hospital discharge, cohorts, ROC curves, positive, parameter, renal tubular cells, urinary, Occurrence, highest, evaluate, recruited, reported, evaluated, hospitalized patient, correlated, reached, highlighting, renal tubular cell, serum biomarker, serum parameter, with COVID-19, 【제목키워드】 COVID-19, Biomarker, Mortality, hospitalized patient,