Mass Screening Is Associated with Low Rates of Acute Kidney Injury among COVID-19 Patients in Hong Kong
© 2021 S. Karger AG, Basel..
INTRODUCTION: Renal involvement in COVID-19 is less well characterized in settings with vigilant public health surveillance, including mass screening and early hospitalization. We assessed kidney complications among COVID-19 patients in Hong Kong, including the association with risk factors, length of hospitalization, critical presentation, and mortality.
METHODS: Linked electronic records of all patients with confirmed COVID-19 from 5 major designated hospitals were extracted. Duplicated records due to interhospital transferal were removed. Primary outcome was the incidence of in-hospital acute kidney injury (AKI). Secondary outcomes were AKI-associated mortality, incident renal replacement therapy (RRT), intensive care admission, prolonged hospitalization and disease course (defined as >90th percentile of hospitalization duration [35 days] and duration from symptom onset to discharge [43 days], respectively), and change of estimated glomerular filtration rate (GFR). Patients were further stratified into being symptomatic or asymptomatic.
RESULTS: Patients were characterized by young age (median: 38.4, IQR: 28.4-55.8 years) and short time (median: 5, IQR: 2-9 days) from symptom onset to admission. Among the 591 patients, 22 (3.72%) developed AKI and 4 (0.68%) required RRT. The median time from symptom onset to in-hospital AKI was 15 days. AKI increased the odds of prolonged hospitalization and disease course by 2.0- and 3.5-folds, respectively. Estimated GFR 24 weeks post-discharge reduced by 7.51 and 1.06 mL/min/1.73 m2 versus baseline (upon admission) in the AKI and non-AKI groups, respectively. The incidence of AKI was comparable between asymptomatic (4.8%, n = 3/62) and symptomatic (3.7%, n = 19/519) patients.
CONCLUSION: The overall rate of AKI among COVID-19 patients in Hong Kong is low, which could be attributable to a vigilant screening program and early hospitalization. Among patients who developed in-hospital AKI, the duration of hospitalization is prolonged and kidney function impairment can persist for up to 6 months post-discharge. Mass surveillance for COVID-19 is warranted in identifying asymptomatic subjects for earlier AKI management.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:52 |
|---|---|
| Enthalten in: |
American journal of nephrology - 52(2021), 2 vom: 05., Seite 161-172 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Chan, Kam Wa [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Acute kidney injury |
|---|
| Anmerkungen: |
Date Completed 26.04.2021 Date Revised 26.04.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1159/000514234 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM323216331 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM323216331 | ||
| 003 | DE-627 | ||
| 005 | 20231225183715.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1159/000514234 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1077.xml |
| 035 | |a (DE-627)NLM323216331 | ||
| 035 | |a (NLM)33765681 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Chan, Kam Wa |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Mass Screening Is Associated with Low Rates of Acute Kidney Injury among COVID-19 Patients in Hong Kong |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 26.04.2021 | ||
| 500 | |a Date Revised 26.04.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021 S. Karger AG, Basel. | ||
| 520 | |a INTRODUCTION: Renal involvement in COVID-19 is less well characterized in settings with vigilant public health surveillance, including mass screening and early hospitalization. We assessed kidney complications among COVID-19 patients in Hong Kong, including the association with risk factors, length of hospitalization, critical presentation, and mortality | ||
| 520 | |a METHODS: Linked electronic records of all patients with confirmed COVID-19 from 5 major designated hospitals were extracted. Duplicated records due to interhospital transferal were removed. Primary outcome was the incidence of in-hospital acute kidney injury (AKI). Secondary outcomes were AKI-associated mortality, incident renal replacement therapy (RRT), intensive care admission, prolonged hospitalization and disease course (defined as >90th percentile of hospitalization duration [35 days] and duration from symptom onset to discharge [43 days], respectively), and change of estimated glomerular filtration rate (GFR). Patients were further stratified into being symptomatic or asymptomatic | ||
| 520 | |a RESULTS: Patients were characterized by young age (median: 38.4, IQR: 28.4-55.8 years) and short time (median: 5, IQR: 2-9 days) from symptom onset to admission. Among the 591 patients, 22 (3.72%) developed AKI and 4 (0.68%) required RRT. The median time from symptom onset to in-hospital AKI was 15 days. AKI increased the odds of prolonged hospitalization and disease course by 2.0- and 3.5-folds, respectively. Estimated GFR 24 weeks post-discharge reduced by 7.51 and 1.06 mL/min/1.73 m2 versus baseline (upon admission) in the AKI and non-AKI groups, respectively. The incidence of AKI was comparable between asymptomatic (4.8%, n = 3/62) and symptomatic (3.7%, n = 19/519) patients | ||
| 520 | |a CONCLUSION: The overall rate of AKI among COVID-19 patients in Hong Kong is low, which could be attributable to a vigilant screening program and early hospitalization. Among patients who developed in-hospital AKI, the duration of hospitalization is prolonged and kidney function impairment can persist for up to 6 months post-discharge. Mass surveillance for COVID-19 is warranted in identifying asymptomatic subjects for earlier AKI management | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute kidney injury | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Cohort | |
| 650 | 4 | |a Renal medicine | |
| 650 | 4 | |a Risk factors | |
| 700 | 1 | |a Hung, Ivan Fan-Ngai |e verfasserin |4 aut | |
| 700 | 1 | |a Tsang, Owen Tak-Yin |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Tak Chiu |e verfasserin |4 aut | |
| 700 | 1 | |a Tso, Eugene Yuk-Keung |e verfasserin |4 aut | |
| 700 | 1 | |a Lung, Kwok Cheung |e verfasserin |4 aut | |
| 700 | 1 | |a Lam, Chung Man |e verfasserin |4 aut | |
| 700 | 1 | |a Chan, Gary Chi-Wang |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Sunny Sze-Ho |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Kam Yan |e verfasserin |4 aut | |
| 700 | 1 | |a Chan, Johnny Wai-Man |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Sydney Chi-Wai |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t American journal of nephrology |d 1991 |g 52(2021), 2 vom: 05., Seite 161-172 |w (DE-627)NLM01263736X |x 1421-9670 |7 nnns |
| 773 | 1 | 8 | |g volume:52 |g year:2021 |g number:2 |g day:05 |g pages:161-172 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1159/000514234 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 52 |j 2021 |e 2 |b 05 |h 161-172 | ||