{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:26:03Z","timestamp":1760232363362,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: Acute kidney injury (AKI) is a common complication among SARS-CoV-2-positive patients who undergo hospitalization. Abundant evidence exists concerning the epidemiology of AKI in patients hospitalized in the ICU for COVID-19 but limited data are available about the occurrence of AKI in SARS-CoV-2-positive patients being hospitalized in a non-ICU setting. Aim and Methods: We have carried out a retrospective study to evaluate frequency and risk factors for AKI among patients consecutively admitted at a third-level university hospital starting from February 2020 (the beginning of the first wave of the SARS-CoV-2 pandemic); all patients were hospitalized outside the ICU. Results: A total of 387 SARS-CoV-2-positive patients were included in the current study; 372 (96.1%) had SARS-CoV-2-related pneumonia. In-hospital AKI onset was recorded in 119 (30.7%) patients, mainly with AKI stage 1 (n = 74, 62.2%); eighteen (4.6%) patients reported AKI stage 3 and six (1.5%) patients had HD-dependent AKI. There were 235 (60.7%) patients with severe COVID-19, and this was more common in patients developing AKI, 94.5% (86\/119) vs. 86.1% (149\/268), p = 0.02. Multivariate regression model (n = 144 patients) reported an independent and significant relationship between AKI occurrence and greater levels of ferritin (p = 0.036), IL-6 (p = 0.032), and azotemia at admission (p = 0.0001). A total of 69 (17.8%) SARS-CoV-2-positive patients died and strong predictors of in-hospital death resulted from age (p &lt; 0.0001), serum ferritin (p &lt; 0.0001) and white blood cells (p &lt; 0.001). According to multivariable analysis (n = 163 patients), there was a consistent link between in-hospital death and AKI stage (1) (p = 0.021) and -stage (2) (p = 0.009). Our results support the notion that AKI occurs frequently among hospitalized COVID-19 patients even in a non-ICU setting and plays a pivotal role in the mortality of this population. Further studies are ongoing in order to clearly establish the frequency of AKI in patients with COVID-19; the mechanisms underlying kidney injury in this population are an area of active investigation. These data provide solid evidence to support close monitoring of COVID-19 patients for the development of AKI and measures taken to prevent this.<\/jats:p>","DOI":"10.3390\/pathogens11111272","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T06:01:28Z","timestamp":1667282488000},"page":"1272","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Acute Kidney Injury in Non-Intensive Care Unit (ICU) Hospitalizations for Coronavirus Disease (COVID-19)"],"prefix":"10.3390","volume":"11","author":[{"given":"Fabrizio","family":"Fabrizi","sequence":"first","affiliation":[{"name":"Division of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo M.","family":"Alfieri","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"},{"name":"Department of Clinical Sciences and Community Health, University School of Medicine, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Molinari","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8574-3548","authenticated-orcid":false,"given":"Francesco","family":"Tamborini","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Tangredi","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Sikharulidze","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2285-9970","authenticated-orcid":false,"given":"Francesco","family":"Blasi","sequence":"additional","affiliation":[{"name":"Respiratory Unit and Adult Cystic Fibrosis Center, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Pathophysiology and Transplantation, University School of Medicine, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5918-0171","authenticated-orcid":false,"given":"Anna","family":"Fracanzani","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, University School of Medicine, 20122 Milano, Italy"},{"name":"Division of Metabolic Internal Medicine, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Monzani","sequence":"additional","affiliation":[{"name":"Division of Sub-Intensive Care Medicine, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7423-9864","authenticated-orcid":false,"given":"Flora","family":"Peyvandi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, University School of Medicine, 20122 Milano, Italy"},{"name":"Division of Internal Medicine, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Castellano","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis and Kidney Transplant, Foundation IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"},{"name":"Department of Clinical Sciences and Community Health, University School of Medicine, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2020, March 11). 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