Epidemiology and outcomes of early-onset AKI in COVID-19-related ARDS in comparison with non-COVID-19-related ARDS: insights from two prospective global cohort studies.
Abstract | BACKGROUND: METHODS: The incidence, demographic profile, management and outcomes of early AKI in patients undergoing invasive mechanical ventilation for COVID-19-related ARDS were described and compared with AKI in a non-COVID-19-related ARDS cohort. RESULTS: Of 18,964 patients in the CCCC data set, 1699 patients with COVID-19-related ARDS required invasive ventilation and had relevant outcome data. Of these, 110 (6.5%) had stage 1, 94 (5.5%) had stage 2, 151 (8.9%) had stage 3 AKI, while 1214 (79.1%) had no AKI within 48 h of initiating invasive mechanical ventilation. Patients developing AKI were older and more likely to have hypertension or chronic cardiac disease. There were geo-economic differences in the incidence of AKI, with lower incidence of stage 3 AKI in European high-income countries and a higher incidence in patients from middle-income countries. Both 28-day and 90-day mortality risk was increased for patients with stage 2 (HR 2.00, p < 0.001) and stage 3 AKI (HR 1.95, p < 0.001). Compared to non-COVID-19 ARDS, the incidence of shock was reduced with lower cardiovascular SOFA score across all patient groups, while hospital mortality was worse in all groups [no AKI (30 vs 50%), Stage 1 (38 vs 58%), Stage 2 (56 vs 74%), and Stage 3 (52 vs 72%), p < 0.001]. The time profile of onset of AKI also differed, with 56% of all AKI occurring in the first 48 h in patients with COVID-19 ARDS compared to 89% in the non-COVID-19 ARDS population. CONCLUSION: AKI is a common and serious complication of COVID-19, with a high mortality rate, which differs by geo-economic location. Important differences exist in the profile of AKI in COVID-19 versus non-COVID-19 ARDS in terms of their haemodynamic profile, time of onset and clinical outcomes.
|
Authors | Bairbre A McNicholas, Emanuele Rezoagli, Andrew J Simpkin, Sankalp Khanna, Jacky Y Suen, Pauline Yeung, Daniel Brodie, Gianluigi Li Bassi, Tai Pham, Giacomo Bellani, John F Fraser, John Laffey, CCCC Consortium |
Journal | Critical care (London, England)
(Crit Care)
Vol. 27
Issue 1
Pg. 3
(01 05 2023)
ISSN: 1466-609X [Electronic] England |
PMID | 36604753
(Publication Type: Journal Article)
|
Copyright | © 2023. The Author(s). |
Topics |
- Humans
- COVID-19
(complications, epidemiology, therapy)
- Prospective Studies
- Risk Factors
- Respiratory Distress Syndrome
(epidemiology, etiology, therapy)
- Acute Kidney Injury
(epidemiology, etiology, therapy)
- Retrospective Studies
- Intensive Care Units
- Hospital Mortality
|
|
Join CureHunter, for free Research Interface BASIC access!
Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease.
Find out why thousands of doctors, pharma researchers and patient activists
around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!
|