Geographic and temporal trends in COVID-associated acute kidney injury in the National COVID Cohort Collaborative
Yoo, YJ; Wilkins, KJ; Alakwaa, F; et. al. N3C and RECOVER Consortia, Clinical Journal of the American Society of Nephrology
Published
August 2023
Journal
Clinical Journal of the American Society of Nephrology
Abstract
AKI is associated with mortality in patients hospitalized with coronavirus disease 2019 (COVID-19); however, its incidence, geographic distribution, and temporal trends since the start of the pandemic are understudied. Electronic health record data were obtained from 53 health systems in the United States in the National COVID Cohort Collaborative. We selected hospitalized adults diagnosed with COVID-19 between March 6, 2020, and January 6, 2022. AKI was determined with serum creatinine and diagnosis codes. Time was divided into 16-week periods (P1–6) and geographical regions into Northeast, Midwest, South, and West. Multivariable models were used to analyze the risk factors for AKI or mortality.
Authors
Yun J Yoo, Kenneth J Wilkins, Fadhl Alakwaa, Feifan Liu, Luke A Torre-Healy, Spencer Krichevsky, Stephanie S Hong, Ankit Sakhuja, Chetan K Potu, Joel H Saltz, Rajiv Saran, Richard L Zhu, Soko Setoguchi, Sandra L Kane-Gill, Sandeep K Mallipattu, Yongqun He, David H Ellison, James B Byrd, Chirag R Parikh, Richard A Moffitt, Farrukh M Koraishy,
Keywords
Adult; Humans; COVID-19/complications/epidemiology; Retrospective Studies; Creatinine; Risk Factors; Acute Kidney Injury/diagnosis; Hospital Mortality
Short Summary
Acute Kidney Injury (AKI) can happen when people get very sick with COVID-19. People in the hospital with COVID are more likely to die if they also get AKI. However, there is not enough research to understand how many people have had AKI since the start of the COVID pandemic or what increases the chances of getting AKI. In this RECOVER study, researchers looked at the electronic health records (EHRs) from 53 hospitals across the United States. They studied adults who were in the hospital with COVID between March 2020 and January 2022. To find out who had AKI, the researchers looked at blood tests that show how well the kidneys are working and diagnosis codes (what doctors use to say what’s wrong with the patient). To understand where people were getting sick, researchers split the country into 4 parts: Northeast, Midwest, South, and West. They also looked at different time periods during the pandemic. Out of 336,473 people in the study, 129,176 (38%) had AKI. People with AKI were also more likely to die than those without AKI. The South and the West had the most cases of AKI. Researchers found that AKI cases went down after the first big wave of COVID, but then went back up during the Delta and Omicron waves. This shows that different types of COVID might affect the kidneys differently. This study is important because it helps us understand how COVID can hurt people’s kidneys, and how it can change over time. It also helps us learn how COVID is linked to things like age, sex, race, and other health problems in different areas of the country.