Acute renal injury in patients with COVID-19, in the critical care unit of a public hospital, Lima-Peru. (preprint)

Objective: To determine the clinical and laboratory characteristics, as well as evaluating the factors associated with mortality in patients with COVID-19 infection and acute kidney injury (AKI) hospitalized in the Intensive Care Unit (ICU) of the Hospital Nacional Arzobispo Loayza. Materials and Methods: Retrospective cohort study, with convenience sampling during the period from April 2020 to March 2021, through the review of medical records data. Inclusion criteria were; patients [≥] 18 years old, with a diagnosis of COVID-19 infection, who were admitted to ICU with normal renal function and developed AKI during their stay in ICU. Exclusion criteria were; patients who developed AKI prior to ICU admission, patients with chronic kidney disease with and without dialysis. Results: A total of 177 medical records that met the inclusion and exclusion criteria were evaluated. The mean age was 57.2+/-13.2 years, 145 (81.4%) were male; comorbidities were: obesity 112(63.3%), arterial hypertension 55 (31.1%) and diabetes mellitus 30(16.9%); the most frequent cause of AKI was hypoperfusion (93%). 83 participants (46.8%) received dialytic support in the intermittent hemodialysis modality. In-hospital mortality was 151 (85.3%) and was higher in the group with stage 3 AKI: 109 (72.2%). The increase in ferritin level (OR: 10.04 (95%CI 4.4-38.46), p<0.001) and APACHE score (OR: 1.75 (95%CI 1.4-2.12), p<0.001), as well as the decrease in PaO2/FiO2 level (OR: 0.85 (95%CI 0.59-0.92), p<0.041, were related to mortality. Conclusions: AKI in ICU patients with COVID-19 infection has a high mortality and the related factors were the increase in APACHE II score and ferritin level, as well as the decrease in PaO2/FiO2 level. Keywords: Acute kidney injury, COVID-19, Intensive care units (MeSH)

Epidemiological profile of patients with stage 5 chronic kidney disease on dialysis with Covid 19 infection in a Public Hospital-Peru (preprint)

IntroductionChronic kidney disease (CKD) in Covid 19 is relevant, however, there are few descriptions and fewer in Peru. Our goal was to describe the epidemiological profile and the factors related to mortality and survival of patients with stage 5 (CKD) on chronic dialysis hospitalized for Covid-19 in a public hospital. MethodsRetrospective case series. Patients with stage 5 CKD, older than 18 years, hospitalized for Covid-19 infection were included. The primary data source was medical records. The clinical and epidemiological profile of the study sample and the factors related to mortality and survival are described. Results105 medical records of patients with CKD 5 were evaluated. 57 (54,29%) were male, with a mean age of 58,59 {+/-} 14,3 years. 84 (80%) patients survived and 21 (20%) died. The main cause of admission to hospitalization was respiratory failure in (80) 76,2%. The hospital stay was 11,76 {+/-} 7,8 days. In the bivariate analysis: the increase in leukocytes, D dimer, ferritin, CRP, LDH and the decrease in lymphocytes, pH, bicarbonate and PaO2/FiO2 were related to mortality. In the multivariate analysis, only CRP> 10 mg/dl [HR: 10.72 (95% CI 1,4-81,58)] and a PaO2/FiO2 [≤] 150 mmHg [HR: 44,40 (95% CI 5,86-336,06)] they were factors related to poor survival. ConclusionsCRP levels> 10mg/dl and PaO2/FiO2 [≤] 150 mmHg are the main factors related to mortality and poor survival in patients with stage 5 CKD hospitalized for Covid-19.