ABSTRACT
Background: Although severe acute respiratory syndrome coronavirus (SARSCoV- 2) infection is primarily a respiratory disease, other organs are also affected. Several pathological studies confirm that SARS-CoV-2 invades kidney tissue causing endothelial damage, glomerular and vascular changes, extensive acute tubular injury and podocyte viral infection. AKI in COVID-19 appears to be frequent, with an AKI incidence of up to 46%, and a 20% requirement for renal replacement therapy (RRT). Patients with AKI show a trend towards worse outcomes and increased mortality. Information on Latin- American population is scarce. Methods: We created a cohort to describe the incidence, risk factors, and outcomes associated with AKI in hospitalized patients with COVID-19 in Mexico City, excluding patients with a known chronic kidney disease. AKI was defined and classified according to KDIGO guidelines. Results: We included 127 patients. 11 patients (8.66%) met the criteria for severe COVID-19, and were more likely to have AKI (81.82% vs. 54.31%, p=0.078). Of the 72 (56.69%) patients that had AKI, 48% were diagnosed at the time of admission. Patients with AKI were more likely to be men (61.7% vs. 42.42%, p=0.043) and older (55.68 years vs. 48.89 years, 0.018). With regards disease severity, 72% of them had a grade 1 AKI. 7 patients (9.72%) had grade 3 AKI, 4 of which needed renal replacement therapy. Overall length of stay was longer in patients with AKI (12 days vs. 7 days, p=0.003). A nonsignificant trend towards stay in critical care units was observed. 3 out of 127 patients died, all 3 had AKI. Conclusions: Amongst our studied population, AKI was associated with a longer length of stay and with a trend towards a more use of critical care services. The lack of association of AKI with mortality could be due to the low overall in-hospital mortality of COVID-19 patients (2.40%).