TY - JOUR
T1 - Long-term outcomes of COVID-19 survivors with hospital AKI
T2 - association with time to recovery from AKI
AU - Lu, Justin Y.
AU - Boparai, Montek S.
AU - Shi, Caroline
AU - Henninger, Erin M.
AU - Rangareddy, Mahendranath
AU - Veeraraghavan, Sudhakar
AU - Mirhaji, Parsa
AU - Fisher, Molly C.
AU - Duong, Tim Q.
N1 - Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the ERA.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Background: Although coronavirus disease 2019 (COVID-19) patients who develop in-hospital acute kidney injury (AKI) have worse short-term outcomes, their long-term outcomes have not been fully characterized. We investigated 90-day and 1-year outcomes after hospital AKI grouped by time to recovery from AKI. Methods: This study consisted of 3296 COVID-19 patients with hospital AKI stratified by early recovery (<48 hours), delayed recovery (2-7 days) and prolonged recovery (>7-90 days). Demographics, comorbidities and laboratory values were obtained at admission and up to the 1-year follow-up. The incidence of major adverse cardiovascular events (MACE) and major adverse kidney events (MAKE), rehospitalization, recurrent AKI and new-onset chronic kidney disease (CKD) were obtained 90-days after COVID-19 discharge. Results: The incidence of hospital AKI was 28.6%. Of the COVID-19 patients with AKI, 58.0% experienced early recovery, 14.8% delayed recovery and 27.1% prolonged recovery. Patients with a longer AKI recovery time had a higher prevalence of CKD (P <. 05) and were more likely to need invasive mechanical ventilation (P <. 001) and to die (P <. 001). Many COVID-19 patients developed MAKE, recurrent AKI and new-onset CKD within 90 days, and these incidences were higher in the prolonged recovery group (P <. 05). The incidence of MACE peaked 20-40 days postdischarge, whereas MAKE peaked 80-90 days postdischarge. Logistic regression models predicted 90-day MACE and MAKE with 82.4 ± 1.6% and 79.6 ± 2.3% accuracy, respectively. Conclusion: COVID-19 survivors who developed hospital AKI are at high risk for adverse cardiovascular and kidney outcomes, especially those with longer AKI recovery times and those with a history of CKD. These patients may require long-term follow-up for cardiac and kidney complications.
AB - Background: Although coronavirus disease 2019 (COVID-19) patients who develop in-hospital acute kidney injury (AKI) have worse short-term outcomes, their long-term outcomes have not been fully characterized. We investigated 90-day and 1-year outcomes after hospital AKI grouped by time to recovery from AKI. Methods: This study consisted of 3296 COVID-19 patients with hospital AKI stratified by early recovery (<48 hours), delayed recovery (2-7 days) and prolonged recovery (>7-90 days). Demographics, comorbidities and laboratory values were obtained at admission and up to the 1-year follow-up. The incidence of major adverse cardiovascular events (MACE) and major adverse kidney events (MAKE), rehospitalization, recurrent AKI and new-onset chronic kidney disease (CKD) were obtained 90-days after COVID-19 discharge. Results: The incidence of hospital AKI was 28.6%. Of the COVID-19 patients with AKI, 58.0% experienced early recovery, 14.8% delayed recovery and 27.1% prolonged recovery. Patients with a longer AKI recovery time had a higher prevalence of CKD (P <. 05) and were more likely to need invasive mechanical ventilation (P <. 001) and to die (P <. 001). Many COVID-19 patients developed MAKE, recurrent AKI and new-onset CKD within 90 days, and these incidences were higher in the prolonged recovery group (P <. 05). The incidence of MACE peaked 20-40 days postdischarge, whereas MAKE peaked 80-90 days postdischarge. Logistic regression models predicted 90-day MACE and MAKE with 82.4 ± 1.6% and 79.6 ± 2.3% accuracy, respectively. Conclusion: COVID-19 survivors who developed hospital AKI are at high risk for adverse cardiovascular and kidney outcomes, especially those with longer AKI recovery times and those with a history of CKD. These patients may require long-term follow-up for cardiac and kidney complications.
KW - PASC
KW - long COVID
KW - major adverse cardiovascular event
KW - major adverse kidney event
KW - predictive modeling
UR - http://www.scopus.com/inward/record.url?scp=85149023900&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85149023900&partnerID=8YFLogxK
U2 - 10.1093/ndt/gfad020
DO - 10.1093/ndt/gfad020
M3 - Article
C2 - 36702551
AN - SCOPUS:85149023900
SN - 0931-0509
VL - 38
SP - 2160
EP - 2169
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
IS - 10
ER -