ABSTRACT
Introduction: AlthoughCOVID-19 and anemia are associated with higher risk for Acute Kidney Injury (AKI), to the best of our knowledge no studies have analyzed the association of admission hemoglobin with Major Adverse Kidney Events (MAKE) in patients with COVID-19 and AKI. Method(s): Retrospective cohort study of 412 hospitalized patients with severe COVID-19. MAKE was defined as a composite of 28-day mortality, progression to AKI stage 3, and renal replacement therapy. A COX regression analysis was used to determine the independent association of hemoglobin level with risk of MAKE. Result(s): The mean age of the 412 patients was 55+/-15 years, 35.9% were male, had a mean Body Mass Index (BMI) of 28.2+/-5.5 kg/m2, and median in-hospital stay was 10 (6-17) days. Overall, patients had a mean hemoglobin level of 12.8+/-2.8g/dL, and 62.1%, 23.8%, 8.7%, and 5.3% presented a 24-hour hemoglobin >13g/dL, 10-13g/dL, 9.9-8g/dL, and < 8g/dL, respectively. Likewise, the 28-day mortality was 20.4%, 22.3% progressed to AKI stage 3 and 9.5% required RRT. The univariate analysis showed that a 24-hour hemoglobin >13 g/dL had a lower risk for 28-day mortality (HR=0.634 [0.503-0.800]), AKI at any stage (0.457 [0.304-687]), progression to AKI stage 3 (0.666 [0.527-0.841]) and RRT requirement (0.626 [0.489-0.801]). After COX regression analysis, a hemoglobin >13g/dL was associated with lower risk to present MAKE (0.541 [0.338-0.866]), independently of age, sex, BMI, diabetes, hypertension, chronic kidney disease, mechanical ventilation, and proinflammatory markers. Conclusion(s):A hemoglobin >13 g/dL level was independently associated with lower risk to present MAKE in hospitalized patients with severe COVID-19. [Formula presented] Conclusion(s): A hemoglobin >13 g/dL level was independently associated with lower risk to present MAKE in hospitalized patients with severe COVID-19. No conflict of interestCopyright © 2023
ABSTRACT
Background: COVID-19 and Acute kidney injury (AKI) are associated with increased mortality and worse kidney outcomes. Although vaccines against SARS-CoV-2 have decreased the rate COVID-19 morbimortality, the role of immune protection against SARS-CoV-2 in the setting of AKI has not been fully yielded Methods: Retrospective case-control study that included clinical and biochemical data of 412 (78 vaccinated and 334 non-vaccinated) patients with severe COVID-19. Cox regression analyses were used to evaluate the effect of the vaccine in mortality and AKI outcomes Results: The mean age of the patients was 55+/-15 years, 64% were women, the mean body mass index was 28+/-5 kg/m2, and median in-hospital stay was 10(6-16) days. The rate of mortality and AKI 3 was 29% vs 10% and 27% vs 13%, for unvaccinated and vaccinated patients, respectively. Cox proportional hazard ratios for survival and prevention of AKI are shown in table 1 Conclusion(s): The SARS-CoV-2 vaccine was independently associated with lower mortality and AKI progression in patients with severe COVID-19.