SARS-CoV-2 infection increases risk of acute kidney injury in a bimodal age distribution

Erica C Bjornstad; Gary Cutter; Pramod Guru; Shina Menon; Isabella Aldana; Scott House; Nancy M Tofil; Catherine A St Hill; Yasir Tarabichi; Valerie M Banner-Goodspeed; Amy B Christie; Surapaneni Krishna Mohan; Devang Sanghavi; Jarrod M Mosier; Girish Vadgaonkar; Allan J Walkey; Rahul Kashyap; Vishakha K Kumar; Vikas Bansal; Karen Boman; Mayank Sharma; Marija Bogojevic; Neha Deo; Lynn Retford; Ognjen Gajic; Katja M Gist; Society of Critical Care Medicine (SCCM) Discovery VIRUS Investigators Group

doi:10.1186/s12882-022-02681-2

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SARS-CoV-2 infection increases risk of acute kidney injury in a bimodal age distribution

Journal article

Open access

Peer reviewed

SARS-CoV-2 infection increases risk of acute kidney injury in a bimodal age distribution

Erica C Bjornstad, Gary Cutter, Pramod Guru, Shina Menon, Isabella Aldana, Scott House, Nancy M Tofil, Catherine A St Hill, Yasir Tarabichi, Valerie M Banner-Goodspeed, …

BMC nephrology, Vol.23(1), pp.63-63

02/11/2022

DOI: 10.1186/s12882-022-02681-2

PMCID: PMC8831033

PMID: 35144572

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https://doi.org/10.1186/s12882-022-02681-2View

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Abstract

Hospitalized patients with SARS-CoV2 develop acute kidney injury (AKI) frequently, yet gaps remain in understanding why adults seem to have higher rates compared to children. Our objectives were to evaluate the epidemiology of SARS-CoV2-related AKI across the age spectrum and determine if known risk factors such as illness severity contribute to its pattern. Secondary analysis of ongoing prospective international cohort registry. AKI was defined by KDIGO-creatinine only criteria. Log-linear, logistic and generalized estimating equations assessed odds ratios (OR), risk differences (RD), and 95% confidence intervals (CIs) for AKI and mortality adjusting for sex, pre-existing comorbidities, race/ethnicity, illness severity, and clustering within centers. Sensitivity analyses assessed different baseline creatinine estimators. Overall, among 6874 hospitalized patients, 39.6% (n = 2719) developed AKI. There was a bimodal distribution of AKI by age with peaks in older age (≥60 years) and middle childhood (5-15 years), which persisted despite controlling for illness severity, pre-existing comorbidities, or different baseline creatinine estimators. For example, the adjusted OR of developing AKI among hospitalized patients with SARS-CoV2 was 2.74 (95% CI 1.66-4.56) for 10-15-year-olds compared to 30-35-year-olds and similarly was 2.31 (95% CI 1.71-3.12) for 70-75-year-olds, while adjusted OR dropped to 1.39 (95% CI 0.97-2.00) for 40-45-year-olds compared to 30-35-year-olds. SARS-CoV2-related AKI is common with a bimodal age distribution that is not fully explained by known risk factors or confounders. As the pandemic turns to disproportionately impacting younger individuals, this deserves further investigation as the presence of AKI and SARS-CoV2 infection increases hospital mortality risk.

Comorbidity

Acute Kidney Injury - epidemiology

Acute Kidney Injury - etiology

Adolescent

Adult

Age Distribution

Age Factors

Aged

Aged, 80 and over

Child

Child, Preschool

Confidence Intervals

COVID-19 - complications

COVID-19 - epidemiology

Creatinine - blood

Global Health - statistics & numerical data

Hospital Mortality

Humans

Inpatients - statistics & numerical data

Middle Aged

Odds Ratio

Registries - statistics & numerical data

SARS-CoV-2

Severity of Illness Index

Details

Title: Subtitle: SARS-CoV-2 infection increases risk of acute kidney injury in a bimodal age distribution
Creators: Erica C Bjornstad - University of Alabama at Birmingham
Gary Cutter - University of Alabama at Birmingham
Pramod Guru - Mayo Clinic, Jacksonville, FL, USA.
Shina Menon - Seattle Children's Hospital
Isabella Aldana - University of Alabama at Birmingham
Scott House - University of Alabama at Birmingham
Nancy M Tofil - University of Alabama at Birmingham
Catherine A St Hill - Allina Health
Yasir Tarabichi - MetroHealth
Valerie M Banner-Goodspeed - Beth Israel Deaconess Medical Center
Amy B Christie - Navicent Health
Surapaneni Krishna Mohan - Panimalar Engineering College
Devang Sanghavi - Mayo Clinic, Jacksonville, FL, USA.
Jarrod M Mosier - University of Arizona
Girish Vadgaonkar - BSES MG Hospital, Mumbai, India.
Allan J Walkey - Boston University
Rahul Kashyap - Mayo Clinic in Arizona
Vishakha K Kumar - Society of Critical Care Medicine
Vikas Bansal - Mayo Clinic in Arizona
Karen Boman - Society of Critical Care Medicine
Mayank Sharma - Mayo Clinic in Arizona
Marija Bogojevic - Mayo Clinic in Arizona
Neha Deo - Mayo Clinic in Arizona
Lynn Retford - Society of Critical Care Medicine
Ognjen Gajic - Mayo Clinic in Arizona
Katja M Gist - University of Colorado Anschutz Medical Campus
Society of Critical Care Medicine (SCCM) Discovery VIRUS Investigators Group
Contributors: Patrick W McGonagill (Contributor) - University of Iowa, Surgery
Resource Type: Journal article
Publication Details: BMC nephrology, Vol.23(1), pp.63-63
DOI: 10.1186/s12882-022-02681-2
PMID: 35144572
PMCID: PMC8831033
NLM abbreviation: BMC Nephrol
ISSN: 1471-2369
eISSN: 1471-2369
Language: English
Date published: 02/11/2022
Academic Unit: Surgery
Record Identifier: 9984322937602771

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