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Abstract: PO0171

Prognostic Significance of Urinary Biomarkers in Patients Hospitalized with COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Menez, Steven, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Moledina, Dennis G., Yale University School of Medicine, New Haven, Connecticut, United States
  • Thiessen Philbrook, Heather, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Wilson, Francis Perry, Yale University School of Medicine, New Haven, Connecticut, United States
  • Obeid, Wassim, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Simonov, Michael, Yale University School of Medicine, New Haven, Connecticut, United States
  • Yamamoto, Yu, Yale University School of Medicine, New Haven, Connecticut, United States
  • Corona villalobos, Celia Pamela, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Chang, Crystal, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Garibaldi, Brian T., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Clarke, William, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Farhadian, Shelli, Yale University School of Medicine, New Haven, Connecticut, United States
  • Dela Cruz, Charles, Yale University School of Medicine, New Haven, Connecticut, United States
  • Coca, Steven G., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Parikh, Chirag R., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Group or Team Name

  • TRIKIC Consortium: Translational Research Investigating Kidney Outcomes in COVID-19
Background

Acute kidney injury (AKI) is common in patients with COVID-19 and associated with poor outcomes. Urinary biomarkers have been associated with adverse kidney outcomes in other settings and may provide additional prognostic information in patients with COVID-19.

Methods

We evaluated 19 urinary biomarkers of injury, inflammation, and repair in patients hospitalized with COVID-19 at 2 academic medical centers between April and June 2020. We associated biomarkers with a primary composite outcome of KDIGO stage 3 AKI, requirement for dialysis, or death within 60 days of admission. We also compared various kidney biomarker levels in the setting of COVID-19 versus other common AKI settings.

Results

Out of 157 patients, 24 (15.3%) experienced the primary outcome. Two-fold higher levels of neutrophil gelatinase-associated lipocalin (NGAL) (HR: 1.53; 95% CI: 1.33-1.76), monocyte chemoattractant protein (MCP-1) (HR: 1.86; 95% CI: 1.48-2.33), and kidney injury molecule-1 (KIM-1) (HR: 2.32; 95% CI: 1.69-3.18) were associated with highest risk of the primary outcome. Higher epidermal growth factor (EGF) levels were associated with a lower risk of the primary outcome (HR 0.52; 95% CI: 0.40-0.69). Individual biomarkers provided moderate discrimination and biomarker combinations improved discrimination for the primary outcome.

Conclusion

Urinary biomarkers are associated with severe kidney complications in patients with COVID-19 and provide valuable information to monitor kidney disease recovery and progression.

Funding

  • NIDDK Support