Renal Manifestations and their Association with Mortality and Length of Stay in COVID-19 Patients at a Safety-net Hospital
, , , , , and | May 12, 2022
About this article
Article Category: Research Article
Published Online: May 12, 2022
Page range: 80 - 88
Received: Dec 20, 2021
Accepted: Apr 27, 2022
DOI: https://doi.org/10.2478/jccm-2022-0010
Keywords
© 2022 Sandra Gomez-Paz, Eric Lam, Luis Gonzalez-Mosquera, Diana Cardenas-Maldonado, Joshua Fogel, Ellen Gabrielle Kagan, Sofia Rubinstein, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Sample Characteristics of 340 COVID-19 Patients
| Variables | M (SD) or Frequency (Percent) |
|---|---|
| Demographics | |
| Age (years) [mean] | 65.7 (15.36) |
| Sex (female) | 123 (36.2) |
| Race/ethnicity | |
| Caucasian | 94 (27.6) |
| African American | 97 (28.5) |
| Hispanic | 117 (34.4) |
| Other | 32 (9.4) |
| Insurance | |
| Private | 67 (19.7) |
| Uninsured/Emergency Medicaid | 56 (16.5) |
| Regular Medicaid | 128 (37.6) |
| Medicare | 89 (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) |
| Ventilation | 154 (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 1 | 158 (46.5) |
| Stage 2 | 65 (19.1) |
| Stage 3 | 117 (34.4) |
| New renal replacement therapy (yes) | 45 (13.2) |
| Renal persistent involvement at discharge | 200 (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
| Variables | Model 1 - Univariate B (SE) | Model 2 - Multivariate B (SE) |
|---|---|---|
| Age (years) | -0.01 (0.001)*** | -0.002 (0.02) |
| Sex (female) | -0.10 (0.04)* | -0.01 (0.04) |
| Race/ethnicity | --- | |
| Caucasian | Reference | |
| African American | <0.001 (0.05) | |
| Hispanic | 0.09 (0.05) | |
| Other | -0.06 (0.07) | |
| Insurance | --- | |
| Private | Reference | |
| Uninsured/Emergency Medicaid | 0.04 (0.07) | |
| Regular Medicaid | -0.09 (0.06) | |
| Medicare | -0.07 (0.06) | |
| Obese (yes) | -0.01 (0.04) | --- |
| CCI | -0.03 (0.01)*** | -0.004 (0.01) |
| 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%) | Reference | Reference |
| High FiO2 (> 55%) | 0.07 (0.05) | -0.09 (0.08) |
| Ventilation | 0.21 (0.05)*** | -0.14 (0.09) |
| 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)** |
| Number organs involved | 0.07 (0.01)*** | 0.04 (0.02)* |
| 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
| Age (years) | 1.03 (1.01, 1.04)*** | 1.09 (1.05, 1.14)*** |
| Sex (female) | 0.86 (0.55, 1.34) | --- |
| Race/ethnicity | ||
| Caucasian | 1.00 | 1.00 |
| African American | 0.52 (0.29, 0.92)* | 0.34 (0.13, 0.91)* |
| Hispanic | 0.70 (0.40, 1.22) | 0.84 (0.29, 2.44) |
| Other | 1.19 (0.51, 2.74) | 0.62 (0.15, 2.53) |
| Insurance | ||
| Private | 1.00 | --- |
| Uninsured/Emergency Medicaid | 1.55 (0.76, 3.16) | |
| Regular Medicaid | 1.28 (0.71, 2.31) | |
| Medicare | 1.88 (0.99, 3.57) | |
| Obese (yes) | 0.92 (0.59, 1.43) | --- |
| CCI | 1.18 (1.08, 1.30)*** | 0.98 (0.78, 1.23) |
| qSOFA | 1.29 (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%) | 1.00 | 1.00 |
| High FiO2 (> 55%) | 14.24 (5.93, 34.16)*** | 17.59 (1.98, 156.41)* |
| Ventilation | 78.00 (31.98, 190.22)*** | 201.93 (15.60, 2,614.08)*** |
| 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) | --- |
| Number organs involved | 2.71 (2.18, 3.38)*** | 1.83 (1.24, 2.71)** |
| 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)*** |