ABSTRACT
Background: Acute kidney injury (AKI) in patients hospitalized with coronavirus disease 2019 (COVID-19) is common and often associated with poor prognosis. Early prediction of AKI that may allow early and effective interventions is essential to improve clinical outcomes. In this study we aimed to validate the USCD-Mayo risk score for AKI in a non-ICU population of patients hospitalized with COVID-19 in a Bolivian referral center. Method(s): One hundred and thirty-nine patients hospitalized with COVID-19 from Hospital Obrero No 2 - CNS in Cochabamba, Bolivia were enrolled in this study. Data for predictor variables was extracted from patient's medical records and the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC -WHO) case report forms at hospital admission. The UCSD-Mayo risk score was calculated using the original equation (Nephrol Dial Transplant. 2017;32(5): 814-822). Patient information was recorded from the time of diagnosis and renal function was followed up daily up to 7 days. AKI was defined using KDIGO serum creatinine criteria. Result(s): A total of 77 patients (55.4%) developed AKI, 75.3% were male with a mean age of 67 years (SD 15). The patients who developed AKI had significantly higher UCSD-Mayo score (>=5 points) than those without AKI (36,4% [n=28] vs. 17,7% [n=11];0.015). Positive and negative predictive values for the optimal cutoff value of >= 5 points in the cohort were 72% and 51% respectively with an odds ratio of 2.65 (95% CI 1.19-5.89;p=0.015). The UCSD-Mayo risk score performance was regular in predicting AKI with a ROC-AUC of 0.632 (95% CI 0.540 -0.725;p = 0.07). As expected, mortality was higher in patients who developed AKI compared to those that did not (57%, [n=44] vs. 40,3% [n=25];0.049). None of the patients who developed AKI required KRT. Conclusion(s): We validated the performance of UCSD-Mayo risk score in predicting hospital-acquired AKI in COVID-19 patients, which showed regular performance. More studies will be needed in order to validate this score in COVID-19 patients. This type of risk assessment tools could help clinicians stratify patients for primary prevention, surveillance and early therapeutic interventions to improve the care and outcomes of COVID-19 patients.