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
Background Acute kidney injury (AKI) is a frequent and severe complication of both COVID-19-related acute respiratory distress syndrome (ARDS) and non-COVID-19-related ARDS. The COVID-19 Critical Care Consortium (CCCC) has generated a global data set on the demographics, management and outcomes of critically ill COVID-19 patients. The LUNG-SAFE study was an international prospective cohort study of patients with severe respiratory failure, including ARDS, which pre-dated the pandemic. 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..
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2023 |
---|---|
Erschienen: |
2023 |
Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
---|---|
Enthalten in: |
Critical care - 27(2023), 1 vom: 05. Jan. |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
McNicholas, Bairbre A. [VerfasserIn] |
---|
Links: |
Volltext [kostenfrei] |
---|
Themen: |
28-day mortality |
---|
Anmerkungen: |
© The Author(s) 2023 |
---|
doi: |
10.1186/s13054-022-04294-5 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
SPR051312433 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | SPR051312433 | ||
003 | DE-627 | ||
005 | 20230527064755.0 | ||
007 | cr uuu---uuuuu | ||
008 | 230508s2023 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1186/s13054-022-04294-5 |2 doi | |
035 | |a (DE-627)SPR051312433 | ||
035 | |a (SPR)s13054-022-04294-5-e | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a McNicholas, Bairbre A. |e verfasserin |4 aut | |
245 | 1 | 0 | |a 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 |
264 | 1 | |c 2023 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a Computermedien |b c |2 rdamedia | ||
338 | |a Online-Ressource |b cr |2 rdacarrier | ||
500 | |a © The Author(s) 2023 | ||
520 | |a Background Acute kidney injury (AKI) is a frequent and severe complication of both COVID-19-related acute respiratory distress syndrome (ARDS) and non-COVID-19-related ARDS. The COVID-19 Critical Care Consortium (CCCC) has generated a global data set on the demographics, management and outcomes of critically ill COVID-19 patients. The LUNG-SAFE study was an international prospective cohort study of patients with severe respiratory failure, including ARDS, which pre-dated the pandemic. 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. | ||
650 | 4 | |a Acute kidney injury |7 (dpeaa)DE-He213 | |
650 | 4 | |a Cohort study |7 (dpeaa)DE-He213 | |
650 | 4 | |a COVID-19 |7 (dpeaa)DE-He213 | |
650 | 4 | |a 28-day mortality |7 (dpeaa)DE-He213 | |
650 | 4 | |a 90-day mortality |7 (dpeaa)DE-He213 | |
650 | 4 | |a Outcome |7 (dpeaa)DE-He213 | |
650 | 4 | |a ARDS |7 (dpeaa)DE-He213 | |
700 | 1 | |a Rezoagli, Emanuele |4 aut | |
700 | 1 | |a Simpkin, Andrew J. |4 aut | |
700 | 1 | |a Khanna, Sankalp |4 aut | |
700 | 1 | |a Suen, Jacky Y. |4 aut | |
700 | 1 | |a Yeung, Pauline |4 aut | |
700 | 1 | |a Brodie, Daniel |4 aut | |
700 | 1 | |a Li Bassi, Gianluigi |4 aut | |
700 | 1 | |a Pham, Tai |4 aut | |
700 | 1 | |a Bellani, Giacomo |4 aut | |
700 | 1 | |a Fraser, John F. |4 aut | |
700 | 1 | |a Laffey, John |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Critical care |d London : BioMed Central, 1997 |g 27(2023), 1 vom: 05. Jan. |w (DE-627)SPR029726166 |w (DE-600)2051256-9 |x 1364-8535 |7 nnns |
773 | 1 | 8 | |g volume:27 |g year:2023 |g number:1 |g day:05 |g month:01 |
856 | 4 | 0 | |u https://dx.doi.org/10.1186/s13054-022-04294-5 |z kostenfrei |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_SPRINGER | ||
951 | |a AR | ||
952 | |d 27 |j 2023 |e 1 |b 05 |c 01 |