ABSTRACT
Background: Acute kidney injury (AKI) can eventually progress into chronic kidney disease (CKD) and end-stage kidney disease (ESKD). COVID-19 is a multisystemic disorder that often causes AKI. The purpose of this study is to assess the frequency and association of clinical variables in patients who developed CKD and ESKD after COVID-19-related AKI. Method(s): We performed a one-year follow-up study with 182 survivor patients admitted to the ward and intensive care unit (ICU) with COVID-19 between April 2020 and March 2021 at Hospital Sao Paulo, Brazil. Patients aged >= 18 years with COVID-19 confirmed on RT-PCR were included. Patients with ESKD before hospitalization were excluded. AKI and CKD were defined according to the KDIGO criteria. We evaluated the frequency of AKI. After it, we compared some clinical variables and outcomes in two subgroups: CKD after CoV-AKI, and non-CKD after COVID-19. Univariate and multivariate analyses were performed. Result(s): 137 (75.3%) patients developed AKI. Of these, 56 (30.8%) needed kidney replacement terapy (KRT) in-hospital. There were higher frequencies of diabetes and hypertension with lower eGFR (84.2+/-24.9, 94.4+/-29.9 ml/min;p=0.08) and mean arterial pressure (74.9+/-9.6, 79.1+/-7.7 mmHg;p=0.03) at baseline in CKD after CoV-AKI group. Hypertension was independently associated with CKD in binary logistic regression [OR: 4.472, 95% CI:1356-13886;p=0.001]. We further observed that all patients who progressed to ESKD (n=7;3.9%) had non-dialytic CKD exacerbated by COVID-19 requiring KRT. Conclusion(s): Hypertension was the independent clinical factor associated with progression to CKD after COVID-19-related AKI. All patients who progressed to ESKD had CKD exacerbated by COVID-19 requiring KRT.
ABSTRACT
OBJECTIVES: The aim of this study was to analyse associations between the COVID-19 pandemic, alcohol consumption and anxiety symptoms among people with self-reported disabilities and family caregivers in Latin America and the Caribbean. STUDY DESIGN: Cross-sectional study with secondary data analysis of the 'Alcohol Use during the COVID-19 pandemic in Latin America and the Caribbean', a Web-based cross-sectional survey conducted by the Pan American Health Organisation between March and June 2020. METHODS: Descriptive analyses were conducted on the individual, social environment characteristics, COVID-19 infection, quarantine compliance, anxiety symptoms (measured by Generalized Anxiety Disorder Scale [GAD-7]) and change in frequency of heavy episodic drinking during the pandemic. Multinomial logistic regression was used to analyse associations among individuals with self-reported disabilities with anxiety symptoms and change in frequency of heavy episodic drinking during the pandemic. RESULTS: Family caregivers were more compliant with COVID-19 restrictive measures than individuals with and without disabilities. The majority of participants with disabilities did not change their drinking patterns during the pandemic (64.3%); however, 28.1% reported increased consumption. People with disabilities were 2.17 times more likely to have severe anxiety symptoms than no anxiety symptoms between March and June 2020 in Latin America and the Caribbean. CONCLUSIONS: This study observed a higher prevalence of the maintenance of heavy episodic drinking behaviour during the early phase of the pandemic in people with disabilities and family caregivers than in people without self-reported disabilities in Latin America and the Caribbean. People with disabilities showed more severe anxiety symptoms than those without disabilities, highlighting the need to develop inclusive health and quality-of-life policies to mitigate the effects of the pandemic in this vulnerable population.