COVID-19 scan on November 2, 2020

A UK study shows that 26% of COVID-19 patients are at risk of kidney damage and death

A PLOS medicine A study late last week found that hospitalized COVID-19 patients had twice the incidence of acute kidney injury (AKI) and three times higher mortality than COVID-19-negative patients. Men, non-white patients, and patients with comorbidities were at increased risk of developing AKI with COVID-19.

A retrospective cohort study examined the relationship between COVID-19 and AKI in 1,161 SARS-CoV-2 positive patients admitted to two emergency hospitals in Derby, UK, from March 5 to 12. Clinical outcomes were followed until May 13. Includes AKI, in-hospital mortality, mechanical ventilation, admission to the intensive care unit, length of stay, etc.

The authors found that COVID-19 patients developed AKI more than twice as often as COVID-19-negative patients (26.2% vs. 12.4%). Elderly (65-84 years), male, non-white ethnic patients, and patients with comorbidities such as cerebrovascular disease, diabetes, and chronic lung-renal disease are at increased risk of developing AKI with COVID-19. became.

Researchers showed significantly higher mortality in AKI COVID-19 patients than in COVID-19-negative patients (60.5% vs. 27.4%,) P <0.001), AKI was an independent predictor of mortality risk (odds ratio) three times higher [OR], 3.27, 95% confidence interval [CI], 2.39-4.48). Patients with COVID-19 and AKI had an almost 4-fold higher risk of death than patients with AKI due to other causes (OR, 3.80, 95% CI, 2.62-5.51).

AKI in hospitalized COVID-19 patients appears to develop later than non-COVID-19 AKI, with direct effects of SARS-CoV-2 nephropathy or high cytokine levels of inflammatory effects (cytokine storms). May be the cause. The mechanism of renal damage remains unknown.

“The practical implication of this observation is that patients with COVID-19 who do not have AKI on admission need to be monitored daily to detect them. [hospital-acquired] “AKI”, the author suggests.
October 30 PLOS Med Survey

Global studies show consistent COVID mortality in all but the elderly

Multilateral modeling research Nature Today, the age-dependent risk of death from COVID-19 has been found to be consistent in people under the age of 65, but the relative risk of older people varies considerably from country to country.

Differences in incidence in nursing homes and varying mortality reports in the elderly make it difficult to quantify cross-country comparisons of infection and mortality patterns. The authors of the study estimated age-specific COVID-19 mortality data from 45 countries and 22 sera by measuring serum levels of SARS-CoV-2 (the virus that causes COVID-19) in the population to estimate epidemic size. A model was developed using the prevalence study. And patterns.

Estimated infection mortality (IFR, or mortality per infection) in all countries was the lowest among ages 5-9, with a predictable mean increase in IFR of 0.59% (95% confidence interval). [CrI], 0.51% to 0.68%), and for every 5 years of age over 10 years, the risk of death for men, especially men over 80 years, increases significantly (IFR 10.8% vs. 5.8% for women).

The authors estimated a total average infection rate of 5.3% (95% CrI, 4.5% to 6.2%) by September 1, ranging from 0.06% in South Korea to 62.4% in Peru, across countries. It shows that the infection level varies widely. ..

This model is promising in identifying countries with lower-than-expected COVID-19 deaths over the age of 65, with 220 fewer deaths reported in Ecuadorians over the age of 65 (per 100,000) and older age. Consistent with underreporting of deaths from COVID-19 in the elderly. Individual (95% CrI, 200-240). The model was also able to identify areas where over-infection was likely to occur in the nursing home population, showing 22.3% IFR (95% CrI, 19.1% to 25.7%) among French nursing home residents, COVID- Emphasizes the high burden of 19. These communities in many high-income countries.

“The results and modeling framework we present show how to use age-specific mortality data to reliably reconstruct the underlying infection level,” the author writes. “May be especially useful in situations where there are no resources to carry. Large-scale, representative serum prevalence studies.”
November 2 Nature Survey