Introduction: Emerging data have described poor clinical outcomes from infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) among African American patients and those from underserved socioeconomic groups. We sought to describe the clinical characteristics and outcomes of acute kidney injury (AKI) in this special population. Methods: This is a retrospective study conducted in an underserved area with a predominance of African American patients with coronavirus disease 2019 (COVID-19). Descriptive statistics were used to characterize the sample population. The onset of AKI and relation to clinical outcomes were determined. Multivariate logistic regression was used to determine factors associated with AKI. Results: Nearly half (49.3%) of the patients with COVID-19 had AKI. Patients with AKI had a significantly lower baseline estimated glomerular filtration rate (eGFR) and higher FiO₂ requirement and D-dimer levels on admission. More subnephrotic proteinuria and microhematuria was seen in these patients, and the majority had a pre-renal urine electrolyte profile. Patients with hospital-acquired AKI (HA-AKI) as opposed to those with community-acquired AKI (CA-AKI) had higher rates of in-hospital death (52 vs. 23%, p = 0.005), need for vasopressors (42 vs. 25%, p = 0.024), and need for intubation (55 vs. 25%, p = 0.006). A history of heart failure was significantly associated with AKI after adjusting for baseline eGFR (OR 3.382, 95% CI 1.121–13.231, p = 0.032). Conclusion: We report a high burden of AKI among underserved COVID-19 patients with multiple comorbidities. Those who had HA-AKI had worse clinical outcomes compared to those who with CA-AKI. A history of heart failure is an independent predictor of AKI in patients with COVID-19.
Cardiorenal Med

中文翻译：

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美国内城医院系统中社区和医院获得性 COVID-19 急性肾损伤的临床特征和结果。


简介：新数据显示，非洲裔美国患者和来自服务不足的社会经济群体的患者感染新型严重急性呼吸综合征冠状病毒 2 (SARS-CoV 2) 后的临床结果不佳。我们试图描述这一特殊人群中急性肾损伤（AKI）的临床特征和结果。方法：这是一项在服务不足的地区进行的回顾性研究，其中主要是患有 2019 年冠状病毒病 (COVID-19) 的非裔美国患者。描述性统计用于描述样本群体的特征。确定 AKI 的发作及其与临床结果的关系。使用多变量逻辑回归来确定与 AKI 相关的因素。结果：近一半 (49.3%) 的 COVID-19 患者患有 AKI。 AKI 患者入院时的基线估计肾小球滤过率 (eGFR) 显着较低，FiO ₂需求和 D-二聚体水平较高。这些患者出现更多的肾病性蛋白尿和微量血尿，大多数患者具有肾前性尿电解质特征。与社区获得性 AKI (CA-AKI) 患者相比，医院获得性 AKI (HA-AKI) 患者的院内死亡率更高（52% vs. 23%， p = 0.005），需要血管加压药（42与 25%， p = 0.024），以及需要插管（55 对 25%， p = 0.006）。调整基线 eGFR 后，心力衰竭病史与 AKI 显着相关（OR 3.382，95% CI 1.121–13.231， p = 0.032）。结论：我们报告，在服务不足且患有多种合并症的 COVID-19 患者中，AKI 负担较高。 与 CA-AKI 患者相比，HA-AKI 患者的临床结果更差。心力衰竭病史是 COVID-19 患者发生 AKI 的独立预测因素。
 心肾医学