Aims The aim of the current study was to evaluate whether tubular markers kidney injury molecule-1 (KIM-1) and N-acetyl-ß-glucosaminidase (NAG) are related to acute kidney injury (AKI) and severe disease in patients with COVID-19. Methods and results In this prospective observational clinical trial we examined a cohort of 80 patients with proof of acute respiratory infection and divided them into a COVID-19 cohort (n = 54) and a control cohort (n = 26). KIM-1 and NAG were measured from urine samples collected in the emergency department. We assessed the development of AKI, admission to the intensive care unit (ICU) and intrahospital death as clinical endpoints. Urinary KIM-1 and NAG were not significantly different between patients with SARS-CoV-2 and those with other respiratory infections (each p = n.s.). Eight patients from the COVID-19 cohort and five of the non-COVID-19-patients suffered from acute kidney injury during their stay. Nine COVID-19 patients and two non-COVID-19 patients were admitted to the ICU. KIM-1 was significantly elevated in COVID-19 patients with, compared to those without AKI (p = 0.005), as opposed to NAG and creatinine (each p = n.s.). Furthermore, KIM-1 was significantly elevated in the patients with COVID-19 that had to be transferred to the ICU (p = 0.015), in contrast to NAG and creatinine (each p = n.s.). Conclusion Assessing KIM-1 in patients with COVID-19 might provide additional value in recognizing AKI at an early stage of disease. Further, KIM-1 might indicate higher risk for clinical deterioration as displayed by admission to the ICU. Graphical abstract
【저자키워드】 COVID-19, Acute kidney injury, KIM-1, NAG, 【초록키워드】 respiratory infections, clinical trial, intensive care, intensive care unit, Acute kidney injury, ICU, emergency department, Kidney injury, Clinical endpoints, Cohort, respiratory infection, AKI, Patient, death, Urine, Acute respiratory infection, respiratory, disease, Admission, early stage, marker, creatinine, severe disease, COVID-19 patient, Clinical deterioration, Abstract, higher risk, other respiratory infections, proof, COVID-19 cohort, urinary, acetyl, FIVE, collected, evaluate, examined, significantly, the patient, elevated, suffered, recognizing, other respiratory infection, were measured, Assessing, non-COVID-19 patient, not significantly different, patients with COVID-19, patients with SARS-CoV-2, transferred, with COVID-19, 【제목키워드】 Biomarker, disease severity, Injury, patients with COVID-19,