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Mass Screening Is Associated with Low Rates of Acute Kidney Injury among COVID-19 Patients in Hong Kong.
Chan, Kam Wa; Hung, Ivan Fan-Ngai; Tsang, Owen Tak-Yin; Wu, Tak Chiu; Tso, Eugene Yuk-Keung; Lung, Kwok Cheung; Lam, Chung Man; Chan, Gary Chi-Wang; Wong, Sunny Sze-Ho; Yu, Kam Yan; Chan, Johnny Wai-Man; Tang, Sydney Chi-Wai.
Afiliação
  • Chan KW; Division of Nephrology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
  • Hung IF; Division of Infectious Diseases, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
  • Tsang OT; State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong SAR, China.
  • Wu TC; Department of Medicine & Geriatrics, Princess Margaret Hospital, Hong Kong SAR, China.
  • Tso EY; Hospital Authority Infectious Disease Centre, Princess Margaret Hospital, Hong Kong SAR, China.
  • Lung KC; Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China.
  • Lam CM; Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong SAR, China.
  • Chan GC; Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
  • Wong SS; Department of Medicine & Geriatrics, Princess Margaret Hospital, Hong Kong SAR, China.
  • Yu KY; Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China.
  • Chan JW; Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong SAR, China.
  • Tang SC; Division of Nephrology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
Am J Nephrol ; 52(2): 161-172, 2021.
Article em En | MEDLINE | ID: mdl-33765681
INTRODUCTION: 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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Programas de Rastreamento / Terapia de Substituição Renal / Injúria Renal Aguda / Teste para COVID-19 / COVID-19 Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Programas de Rastreamento / Terapia de Substituição Renal / Injúria Renal Aguda / Teste para COVID-19 / COVID-19 Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Ano de publicação: 2021 Tipo de documento: Article