Characteristics of cardiac injury complicating with acute kidney injury and mortality risk in coronavirus disease 2019(COVID-19)patients

Objectives:This study aimed to identify the clinical features of cardiac injury complicating with acute kidney injury(AKI)and its risk for a fatal outcome in patients infected with coronavirus disease 2019(COVID-19)pneumonia.Methods:Initial signs and symptoms and clinical laboratory,radiological,and treatment information were obtained from seven hospitals in China from January 23,2020,to March 15,2020.Results:Of 438 patients,36(8.22%)displayed isolated cardiac injury,17(3.88%)had isolated AKI,and 17(3.88%)displayed cardiac injury complicating with AKI.Compared with patients without cardiac injury or AKI,patients with isolated cardiac injury,isolated AKI,and cardiac injury complicating with AKI were older(55,65,74 vs.48 years,P＜0.0001)and critically severe.More patients displayed fatigue,dyspnea,and comorbidities in the group with cardiac injury complicating with AKI.Moreover,the indexes reflecting myocardial,renal,liver,and coagulation dysfunctions and infection-related factors were significantly different among the four groups.After adjustment for covariates,patients with cardiac injury complicating with AKI had a higher hazard ratio for mortality(6.64;95%confidence interval,1.51-29.30).Conclusion:Cardiac injury complicating with kidney injury significantly increased the risk for in-hospital mortality in COVID-19 pneumonia patients.Therefore,early detection at admission and careful monitoring of myocardial and renal injury through biomarkers during hospitalization is recommended to reduce the harm to patients.