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Caturano A, Galiero R, Vetrano E, Medicamento G, Alfano M, Beccia D, Brin C, Colantuoni S, Di Salvo J, Epifani R, Nevola R, Marfella R, Sardu C, Coppola C, Scarano F, Maggi P, Calabrese C, De Lucia Sposito P, Rescigno C, Sbreglia C, Fraganza F, Parrella R, Romano A, Calabria G, Polverino B, Pagano A, Numis FG, Bologna C, Nunziata M, Esposito V, Coppola N, Maturo N, Nasti R, Di Micco P, Perrella A, Adinolfi LE, Di Domenico M, Monda M, Russo V, Ruggiero R, Docimo G, Rinaldi L, Sasso FC. Impact of Acute Kidney Injury on the COVID-19 In-Hospital Mortality in Octogenarian Patients: Insights from the COVOCA Study. Life (Basel) 2024; 14:86. [PMID: 38255701 PMCID: PMC10817510 DOI: 10.3390/life14010086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/01/2024] [Accepted: 01/02/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND AND AIMS The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has fundamentally reshaped the landscape of global public health, with some people suffering more adverse clinical outcomes than others. The aim of this study is to deepen our understanding of the specific impact of acute kidney injury (AKI) on the in-hospital mortality in octogenarian patients with COVID-19. METHODS This is a prospective observational cohort study, which involved 23 COVID-19 hospital units in the Campania Region, Italy. Exposure variables were collected during hospital admission and at discharge. Only patients aged ≥80 years were deemed eligible for the study. RESULTS 197 patients were included in the study (median age 83.0 [82.0-87.0] years; 51.5% men), with a median duration of hospitalization of 15.0 [8.0-25.0] days. From the multivariable Cox regression analysis, after the application of Šidák correction, only the respiratory rate (HR 1.09, 95% CI: 1.04 to 1.14; p < 0.001) and AKI development (HR: 3.40, 95% CI: 1.80 to 6.40; p < 0.001) were independently associated with the primary outcome. Moreover, the Kaplan-Meier analysis showed a significantly different risk of in-hospital mortality between patients with and without AKI (log-rank: <0.0001). CONCLUSIONS In our investigation, we identified a significant association between AKI and mortality rates among octogenarian patients admitted for COVID-19. These findings raise notable concerns and emphasize the imperative for vigilant monitoring of this demographic cohort.
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Affiliation(s)
- Alfredo Caturano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Raffaele Galiero
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
| | - Erica Vetrano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
| | - Giulia Medicamento
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
| | - Maria Alfano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
| | - Domenico Beccia
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
| | - Chiara Brin
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
| | - Sara Colantuoni
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
| | - Jessica Di Salvo
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
| | - Raffaella Epifani
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
| | - Riccardo Nevola
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
- Ospedale Evangelico Betania, 80147 Naples, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
| | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
| | - Carmine Coppola
- Hepatology Unit, Internal Medicine, Area Stabiese Hospital, 80053 Naples, Italy;
| | - Ferdinando Scarano
- COVID Center “S. Anna e SS. Madonna della Neve” Hospital, 80042 Boscotrecase, Italy;
| | - Paolo Maggi
- U.O.C. Infectious and Tropical Diseases, S. Anna e S. Sebastiano Hospital, 81100 Caserta, Italy;
| | - Cecilia Calabrese
- U.O.C. Pneumologia Vanvitelli, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, AORN Ospedali dei Colli, Via Leonardo Bianchi, 80131 Naples, Italy;
| | | | - Carolina Rescigno
- U.O.C. Infectious Diseases and Neurology, Cotugno Hospital, 80131 Naples, Italy;
| | - Costanza Sbreglia
- U.O.C. Infectious Diseases of the Elderly, Cotugno Hospital, 80131 Naples, Italy;
| | - Fiorentino Fraganza
- U.O.C. Anestesia and Intensive Care Unit, Cotugno Hospital, 80131 Naples, Italy;
| | - Roberto Parrella
- U.O.C. Respiratory Infectious Diseases, Cotugno Hospital, 80131 Naples, Italy;
| | | | - Giosuele Calabria
- IXth Division of Infectious Diseases and Interventional Ultrasound, Cotugno Hospital, 80131 Naples, Italy;
| | | | - Antonio Pagano
- Emergency and Acceptance Unit, “Santa Maria delle Grazie” Hospital, 80078 Pozzuoli, Italy; (A.P.); (F.G.N.)
| | - Fabio Giuliano Numis
- Emergency and Acceptance Unit, “Santa Maria delle Grazie” Hospital, 80078 Pozzuoli, Italy; (A.P.); (F.G.N.)
| | | | | | - Vincenzo Esposito
- IVth Division of Immunodeficiency and Gender Infectious Diseases, Cotugno Hospital, 80131 Naples, Italy;
| | - Nicola Coppola
- COVID Center, Department of Mental Health and Public Medicine, A.O.U. Vanvitelli, 80131 Naples, Italy;
| | - Nicola Maturo
- U.O.S.D. Infectious Diseases Emergency and Acceptance, Cotugno Hospital, 80131 Naples, Italy;
| | - Rodolfo Nasti
- Emergency Division, A.O.R.N. “Antonio Cardarelli”, 80131 Naples, Italy;
| | - Pierpaolo Di Micco
- Department of Internal Medicine, Fatebenefratelli Hospital of Naples, 80123 Naples, Italy;
| | | | - Luigi Elio Adinolfi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
| | - Marina Di Domenico
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Marcellino Monda
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Vincenzo Russo
- Department of Biology, College of Science and Technology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, PA 19122, USA;
- Division of Cardiology, Department of Medical Translational Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Roberto Ruggiero
- Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Giovanni Docimo
- Unit of Thyroid Surgery, Department of Medical and Advanced Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Luca Rinaldi
- Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy; (R.G.); (E.V.); (G.M.); (M.A.); (D.B.); (C.B.); (S.C.); (J.D.S.); (R.E.); (R.N.); (R.M.); (C.S.); (L.E.A.); (F.C.S.)
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