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Renal Manifestations and their Association with Mortality and Length of Stay in COVID-19 Patients at a Safety-net Hospital Cover

Renal Manifestations and their Association with Mortality and Length of Stay in COVID-19 Patients at a Safety-net Hospital

Open Access
|May 2022

Figures & Tables

Sample Characteristics of 340 COVID-19 Patients

VariablesM (SD) or Frequency (Percent)
Demographics
Age (years) [mean]65.7 (15.36)
Sex (female)123 (36.2)

Race/ethnicity
   Caucasian94 (27.6)
   African American97 (28.5)
   Hispanic117 (34.4)
   Other32 (9.4)

Insurance
   Private67 (19.7)
   Uninsured/Emergency Medicaid56 (16.5)
   Regular Medicaid128 (37.6)
   Medicare89 (26.2)

Comorbidities
Obese (yes)128 (37.6)
CCI [mean]3.6 (2.48)

Disease severity
qSOFA [mean]2.0 (0.66)
ICU (yes)239 (70.3)
Intubation admission (yes)35 (10.3)

Oxygen requirement hospitalization
   None/Low FiO2 (< 55%)98 (28.8)
   High FiO2 (> 55%)88 (25.9)
   Ventilation154 (45.3)

Treatment management
Vasopressor (yes)109 (32.1)
Antibiotic (yes)325 (95.6)
NSAID (yes)85 (25.0)
ACEi/ARBS (yes)44 (12.9)
Antiviral (yes)11 (3.2)
Antimalarial (yes)294 (86.5)
Steroid (yes)134 (39.4)
Convalescent plasma (yes)35 (10.3)

Interleukin inhibitor (yes)47 (13.8)
Anticoagulant (yes)91 (26.8)

Organ involvement
Number organs involved [mean]5.3 (1.54)

Renal
Creatinine peak [mean]3.6 (3.25)
Blood urea nitrogen peak [mean]72.7 (53.13)
Calcium during hospitalization [mean]8.3 (0.81)
Sodium on admission [mean]139.0 (7.17)
Days to renal involvement [mean]2.8 (3.98)

AKIN stage
     Stage 1158 (46.5)
     Stage 265 (19.1)
     Stage 3117 (34.4)
New renal replacement therapy (yes)45 (13.2)
Renal persistent involvement at discharge200 (58.8)
(yes)
Specific gravity [mean]1.02 (0.01)

Outcomes
Mortality (yes)185 (54.4)
Length of stay (days) [mean]12.9 (13.18)

Linear Regression Analyses for Length of Stay

VariablesModel 1 - Univariate B (SE)Model 2 - Multivariate B (SE)
Demographics
Age (years)-0.01 (0.001)***-0.002 (0.02)
Sex (female)-0.10 (0.04)*-0.01 (0.04)

Race/ethnicity ---
   CaucasianReference
   African American<0.001 (0.05)
   Hispanic0.09 (0.05)
   Other-0.06 (0.07)

Insurance ---
   PrivateReference
   Uninsured/Emergency Medicaid0.04 (0.07)
   Regular Medicaid-0.09 (0.06)
   Medicare-0.07 (0.06)

Comorbidities
Obese (yes)-0.01 (0.04)---
CCI-0.03 (0.01)***-0.004 (0.01)

Disease severity
qSOFA-0.05 (0.03)---
ICU (yes)0.19 (0.04)***0.07 (0.08)
Intubation admission (yes)-0.08 (0.07)---

Oxygen requirement hospitalization
   None/Low FiO2 (< 55%)ReferenceReference
   High FiO2 (> 55%)0.07 (0.05)-0.09 (0.08)
   Ventilation0.21 (0.05)***-0.14 (0.09)

Treatment management
Vasopressor (yes)0.15 (0.04)***-0.05 (0.05)
Antibiotic (yes)0.24 (0.10)*0.12 (0.08)
NSAID (yes)0.07 (0.05)---
ACEi/ARBS (yes)0.05 (0.06)---
Antiviral (yes)0.17 (0.11)---
Antimalarial (yes)0.07 (0.06)---
Steroid (yes)0.28 (0.04)***0.10 (0.04)*
Convalescent plasma (yes)0.49 (0.06)***0.19 (0.06)**
Interleukin inhibitor (yes)0.35 (0.05)***0.02 (0.06)
Anticoagulant (yes)0.26 (0.04)***0.10 (0.04)**

Organ involvement
Number organs involved0.07 (0.01)***0.04 (0.02)*

Renal
Creatinine peak----0.11 (0.11)
Blood urea nitrogen peak---0.001 (<0.001)**
Calcium during hospitalization---0.02 (0.02)
Sodium on admission----0.01 (0.002)*
Days to renal involvement---0.19 (0.05)***
AKIN stage---
     Stage 1 Reference
     Stage 2 0.04 (0.05)
     Stage 3 0.05 (0.08)
New renal replacement therapy (yes)---0.19 (0.06)**
Renal persistent involvement at discharge (yes)----0.12 (0.04)**
Constant---1.28 (0.36)***

Logistic Regression Analyses for Mortality

VariablesModel 1 - Univariate OR (95% CI)Model 2 - Multivariate OR (95% CI)
Demographics
Age (years)1.03 (1.01, 1.04)***1.09 (1.05, 1.14)***
Sex (female)0.86 (0.55, 1.34)---

Race/ethnicity
   Caucasian1.001.00
   African American0.52 (0.29, 0.92)*0.34 (0.13, 0.91)*
   Hispanic0.70 (0.40, 1.22)0.84 (0.29, 2.44)
Other1.19 (0.51, 2.74)0.62 (0.15, 2.53)

Insurance
   Private1.00---
   Uninsured/Emergency Medicaid1.55 (0.76, 3.16)
   Regular Medicaid1.28 (0.71, 2.31)
   Medicare1.88 (0.99, 3.57)

Comorbidities
Obese (yes)0.92 (0.59, 1.43)---
CCI1.18 (1.08, 1.30)***0.98 (0.78, 1.23)

Disease severity
qSOFA1.29 (0.93, 1.79)---
ICU (yes)19.44 (9.99, 37.84)***0.91 (0.12, 7.08)
Intubation admission (yes)4.62 (1.86, 11.44)**0.45 (0.12, 1.67)

Oxygen requirement hospitalization
   None/Low FiO2 (< 55%)1.001.00
   High FiO2 (> 55%)14.24 (5.93, 34.16)***17.59 (1.98, 156.41)*
   Ventilation78.00 (31.98, 190.22)***201.93 (15.60, 2,614.08)***

Treatment management
Vasopressor (yes)9.64 (5.26, 17.66)***0.96 (0.30, 3.02)
Antibiotic (yes)2.48 (0.83, 7.43)---
NSAID (yes)1.05 (0.64, 1.72)---
ACEi/ARBS (yes)0.54 (0.28, 1.02)---
Antiviral (yes)8.80 (1.11, 69.53)*2.56 (0.19, 34.07)
Antimalarial (yes)0.66 (0.35, 1.26)---
Steroid (yes)2.39 (1.52, 3.76)***1.20 (0.48, 3.03)
Convalescent plasma (yes)1.13 (0.56, 2.29)---
Interleukin inhibitor (yes)1.95 (1.01, 3.76)*1.08 (0.34, 3.47)
Anticoagulant (yes)1.03 (0.64, 1.67)---

Organ involvement
Number organs involved2.71 (2.18, 3.38)***1.83 (1.24, 2.71)**

Renal
Creatinine peak---35.27 (2.81, 442.06)**
Blood urea nitrogen peak---0.98 (0.97, 0.996)*
Calcium during hospitalization---1.49 (0.93, 2.39)
Sodium on admission---1.03 (0.97, 1.09)
Days to renal involvement---1.21 (0.37, 3.93)
AKIN stage---
     Stage 1 1.00
     Stage 2 1.09 (0.34, 3.50)
     Stage 3 0.84 (0.13, 5.59)
New renal replacement therapy (yes)---0.27 (0.07, 1.10)
Renal persistent involvement at discharge(yes) ---4.47 (1.99, 10.06)***
DOI: https://doi.org/10.2478/jccm-2022-0010 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
Language: English
Page range: 80 - 88
Submitted on: Dec 20, 2021
|
Accepted on: Apr 27, 2022
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Published on: May 12, 2022
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2022 Sandra Gomez-Paz, Eric Lam, Luis Gonzalez-Mosquera, Diana Cardenas-Maldonado, Joshua Fogel, Ellen Gabrielle Kagan, Sofia Rubinstein, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.