Association of acute kidney injury and clinical outcomes in patients with COVID-19 in Shenzhen, China: a retrospective cohort study.

Tan, Li-Shan; Huang, Xiao-Yan; Wang, Yun-Feng; Jia, Yan; Pang, Qi-Lin; Zhang, Wei-Xing; Xiong, Zu-Ying; Huang, Lei; Li, Jin-Xiu

BACKGROUND Acute kidney injury (AKI) was found in some patients with COVID-19 pneumonia and accompanied with poor outcomes. The objective of this study was to investigate the association of AKI with clinical outcomes in COVID-19 patients. METHODS In this cohort study, we reviewed electronic medical data from patients with COVID-19 in Shenzhen from January 11 to February 19, 2020. Clinical features and clinical outcomes in COVID-19 patients with and without AKI were analyzed. Further, we evaluated the association between AKI development and clinical outcomes. RESULTS In this study, 9.6% patients developed AKI during hospitalization. Those with AKI presented older age, severer pneumonia, more comorbidity and lower lymphocyte count. Totally, more patients (77.5%) had primary composite outcomes (intensive care unit (ICU) admission, use of high-flow nasal cannula (HFNC) and mechanical ventilation) in AKI group compared to non-AKI group (2.9%) during the observation period. The median length of stay (LOS) and ICU stay were longer among those with AKI. After adjusted for related covariates, AKI development was independently correlated with LOS (β (95% CI): 9.16 (3.87-14.46)), rather than primary outcomes (HR (95% CI): 1.34 (0.56-3.21)) in COVID-19 patients. CONCLUSIONS The development of AKI was not one of the reasons for ICU admission, use of HFNC and mechanical ventilation, but a kind of manifestation of severe illness in COVID-19 hospitalized patients.