Acute Kidney Injury Is Associated With In-hospital Mortality in Older Patients With COVID-19

Abstract

The epidemic of COVID-19 presents a special threat to elderly adults. However, information on kidney damage in elderly patients with COVID-19 is limited. Acute kidney injury (AKI) is common in hospitalized adults and associated with a poor prognosis. We sought to explore the association between AKI and mortality in elderly patients with COVID-19. We conducted a retrospective, observational cohort study in a large tertiary-care university hospital in Wuhan, China. All consecutive inpatients elderly than 65 years with COVID-19 were enrolled in this cohort. Demographic data, laboratory values, comorbidities, treatments, and clinical outcomes were all collected. Data were compared between patients with AKI and without AKI. The association between AKI and mortality was analyzed. Of 1764 in-hospital patients, 882 elderly cases were included in this cohort. The median age was 71 years (interquartile range [IQR]: 68-77), 440 (49.9%) were man. The most presented comorbidity was cardiovascular diseases (58.2%), followed by diabetes (31.4%). Of 882 elderly patients, 115 (13%) developed AKI and 128 (14.5%) died. Patients with AKI had higher mortality than those without AKI (68 [59.1%] vs 60 [7.8%]; P < 0.001). Multivariable Cox regression analysis showed that increasing odds of in-hospital mortality associated with higher interleukin-6 on admission, myocardial injury and AKI. AKI is not an uncommon complication in elderly patients with COVID-19 but is associated with high risk of death. Physicians should aware the risk of AKI in elderly patients with COVID-19.