| Autor: |
Filev R; Department of Nephrology, Internal Disease Clinic, University Hospital 'Saint Anna', 1750 Sofia, Bulgaria.; Faculty of Medicine, Medical University Sofia, 1504 Sofia, Bulgaria., Lyubomirova M; Department of Nephrology, Internal Disease Clinic, University Hospital 'Saint Anna', 1750 Sofia, Bulgaria.; Faculty of Medicine, Medical University Sofia, 1504 Sofia, Bulgaria., Hristova J; Faculty of Medicine, Medical University Sofia, 1504 Sofia, Bulgaria.; Department of Clinical Laboratory, University Hospital 'Alexandrovska', 1431 Sofia, Bulgaria., Bogov B; Department of Nephrology, Internal Disease Clinic, University Hospital 'Saint Anna', 1750 Sofia, Bulgaria.; Faculty of Medicine, Medical University Sofia, 1504 Sofia, Bulgaria., Kalinov K; Head Biometrics Group, Comac-Medical Ltd., 1404 Sofia, Bulgaria., Svinarov D; Faculty of Medicine, Medical University Sofia, 1504 Sofia, Bulgaria.; Department of Clinical Laboratory, University Hospital 'Alexandrovska', 1431 Sofia, Bulgaria., Rostaing L; Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, Grenoble University Hospital, 38043 Grenoble, France.; Medicine Faculty, University of Grenoble Alpes, 38000 Grenoble, France. |
| Abstrakt: |
In a prospective, observational, non-interventional, single-center study, we assessed various plasma and urinary biomarkers of kidney injury (neutrophil gelatinase-associated Lipocain [NGAL], kidney-injury molecule-1 [KIM-1], and interleukin-18 [IL-18]); inflammation (IL-6, C-reactive protein [CRP]); plus angiotensin converting enzyme 2 (ACE2) in 120 COVID-19 patients (of whom 70 had chronic kidney disease (CKD) at emergency-department (ED) admission). Our aim was to correlate the biomarkers with the outcomes (death, acute kidney injury [AKI]). All patients had received a chest-CT scan at admission to calculate the severity score (0-5). Biomarkers were also assessed in healthy volunteers and non-COVID-19-CKD patients. These biomarkers statistically differed across subgroups, i.e., they were significantly increased in COVID-19 patients, except for urinary (u)KIM1 and uIL-18. Amongst the biomarkers, only IL-6 was independently associated with mortality, along with AKI and not using remdesivir. Regarding the prediction of AKI, only IL-6 and uKIM1 were significantly elevated in patients presenting with AKI. However, AKI could not be predicted. Having high baseline IL-6 levels was associated with subsequent ventilation requirement and death. The mortality rate was almost 90% when the chest CT-scan severity score was 3 or 4 vs. 6.8% when the severity score was 0-2 ( p < 0.0001). |
