Acute cardiac injury and acute kidney injury associated with severity and mortality in patients with COVID-19

W.-X. Li, W. Xu, C.-L. Huang, L. Fei, X.-D. Xie, Q. Li, L. Chen

Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China. liqiang66601@163.com

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• Infectious Diseases

OBJECTIVE: To determine the incidence and risk factors for acute cardiac injury (ACI) and acute kidney injury (AKI), and then investigate their effect on severity and mortality in patients with COVID-19.

PATIENTS AND METHODS: A total of 1249 patients with COVID-19 were included in this retrospective study. Predictors of ACI and AKI were investigated. Multivariable-logistic regression models were used to determine the association of ACI (or AKI) with severity and mortality.

RESULTS: Median age of patients was 36 years and 61.9% were male. ACI and AKI were observed in 53 (4.2%) and 91 (7.3%) of patients, respectively. Patients with age > 60 years, chronic heart disease, decreased lymphocyte and increased CRP, PCT, and ESR on hospital admission, and Lopinavir/Ritonavir use showed higher odds of ACI. Patients with age > 60 years, male, obesity, hypertension, chronic kidney disease, decreased lymphocyte and increased CRP, PCT, and ESR on hospital admission showed higher odds of AKI. Increased Hs-cTnI (> 300 ng/L), Pro-BNP (> 2500 pg/ml) and decreased e-GFR (< 60 ml/min) revealed higher adjusted mortality.

CONCLUSIONS: ACI and AKI were not common in COVID-19 patients in Shanghai, China. However, patients with ACI/AKI had higher severity-rate and mortality-rate when compared to those without ACI/AKI.

 

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