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Article: Mass Screening Is Associated with Low Rates of Acute Kidney Injury among COVID-19 Patients in Hong Kong

TitleMass Screening Is Associated with Low Rates of Acute Kidney Injury among COVID-19 Patients in Hong Kong
Authors
KeywordsCOVID-19
Renal medicine
Acute kidney injury
Risk factors
Cohort
Issue Date2021
PublisherS Karger AG. The Journal's web site is located at http://www.karger.com/AJN
Citation
American Journal of Nephrology, 2021, v. 52 n. 2, p. 161-172 How to Cite?
AbstractIntroduction: 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. © 2021 S. Karger AG, Basel
Persistent Identifierhttp://hdl.handle.net/10722/304702
ISSN
2020 Impact Factor: 3.754
2020 SCImago Journal Rankings: 1.394
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChan, KW-
dc.contributor.authorHung, FNI-
dc.contributor.authorTsang, OT-
dc.contributor.authorWu, TC-
dc.contributor.authorTso, EY-
dc.contributor.authorLung, KC-
dc.contributor.authorLam, CM-
dc.contributor.authorChan, GCW-
dc.contributor.authorWong, SS-
dc.contributor.authorYu, KY-
dc.contributor.authorChan, JW-
dc.contributor.authorTang, SCW-
dc.date.accessioned2021-10-05T02:33:55Z-
dc.date.available2021-10-05T02:33:55Z-
dc.date.issued2021-
dc.identifier.citationAmerican Journal of Nephrology, 2021, v. 52 n. 2, p. 161-172-
dc.identifier.issn0250-8095-
dc.identifier.urihttp://hdl.handle.net/10722/304702-
dc.description.abstractIntroduction: 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. © 2021 S. Karger AG, Basel -
dc.languageeng-
dc.publisherS Karger AG. The Journal's web site is located at http://www.karger.com/AJN-
dc.relation.ispartofAmerican Journal of Nephrology-
dc.rightsAmerican Journal of Nephrology. Copyright © S Karger AG.-
dc.rightsThis is the peer-reviewed but unedited manuscript version of the following article: [insert full citation, e.g., Cytogenet Genome Res 2014;142:227–238 (DOI: 10.1159/000361001)]. The final, published version is available at http://www.karger.com/?doi=[insert DOI number]. OR This is the un-reviewed and unedited manuscript version of the following article: [insert full citation, e.g., Cytogenet Genome Res 2014;142:227–238 (DOI: 10.1159/000361001)]. The final, published version is available at http://www.karger.com/?doi=[insert DOI number]. -
dc.subjectCOVID-19-
dc.subjectRenal medicine-
dc.subjectAcute kidney injury-
dc.subjectRisk factors-
dc.subjectCohort-
dc.titleMass Screening Is Associated with Low Rates of Acute Kidney Injury among COVID-19 Patients in Hong Kong-
dc.typeArticle-
dc.identifier.emailChan, KW: chriskwc@hku.hk-
dc.identifier.emailHung, FNI: ivanhung@hkucc.hku.hk-
dc.identifier.emailYu, KY: karenkyy@hku.hk-
dc.identifier.emailTang, SCW: scwtang@hku.hk-
dc.identifier.authorityHung, FNI=rp00508-
dc.identifier.authorityTang, SCW=rp00480-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1159/000514234-
dc.identifier.pmid33765681-
dc.identifier.scopuseid_2-s2.0-85103571150-
dc.identifier.hkuros326403-
dc.identifier.volume52-
dc.identifier.issue2-
dc.identifier.spage161-
dc.identifier.epage172-
dc.identifier.isiWOS:000642445700008-
dc.publisher.placeSwitzerland-

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