The incidence, risk factors and impact of acute kidney injury in hospitalized patients due to COVID-19
Medicina
; 81(6):922-930, 2021.
Article
in English
| GIM | ID: covidwho-1787173
ABSTRACT
The incidence of acute kidney injury (AKI) in hospitalized patients with COVID-19 is variable, being as- sociated with worse outcomes. The objectives of the study were to evaluate the incidence, risk factors (considering demographic characteristics, comorbidities, initial clinical presentation and associated complications) and impact of AKI in subjects hospitalized for COVID-19 in two third-level hospitals in C..rdoba, Argentina. A retrospective cohort study was conducted. We included 448 adults who were consecutively hospitalized for COVID-19 between March 3 and October 31, 2020 and were followed throughout the hospitalization. The incidence of AKI was 19% (n = 85;stage I = 43, stage II = 17, and stage III = 25, 18 required renal replacement therapy). In the multivariate analysis, the variables that were independently associated with AKI were age (for every 10 years, adjusted odd ratio [95%CI] = 1.30 [1.04-1.63], p = 0.022), history of chronic kidney disease -CKD- (9.92 [4.52-21.77], p < 0.001), blood neutrophil count at admission -BNCA- (for every increase of 1000 BNCA, 1.09 [1.01-1.18], p = 0.037) and requirement for mechanical ventilation -MV- (6.69 [2.24-19.90], p = 0.001). AKI was associated with longer hospitalization, higher admission (63.5 vs. 29.7%;p < 0.001) and longer stay in the intensive care unit, a positive association with respiratory bacterial superinfection, sepsis, respiratory distress syndrome, MV requirement and mortality (mortality without AK I = 12.4% vs with AKI = 47.1%;stage I = 26%, stage II = 41% and stage III = 88%;p < 0.001). AKI was independently associated with higher mortality (3.32 [1.6-6.9], p = 0.001). In conclusion, the incidence of AKI in adults hospitalized for COVID-19 was 19% and had a clear impact on morbidity and mortality. The independent risk factors for AKI were Age, CKD, BNCA and MV.
mortality; viral diseases; risk factors; coronavirus disease 2019; human diseases; cohort studies; pandemics; public health; disease incidence; hospital admission; complications; epidemiology; comorbidity; clinical aspects; tertiary health care; hospitals; retrospective studies; adults; disease course; kidney transplant; transplantation; surgery; surgical operations; age; chronic diseases; kidney diseases; neutrophils; blood; artificial respiration; severe course; hospital stay; intensive care; intensive care units; respiratory diseases; bacterial diseases; sepsis; acute respiratory distress syndrome; morbidity; acute course; Severe acute respiratory syndrome coronavirus 2; man; Argentina; Severe acute respiratory syndrome-related coronavirus; Betacoronavirus; Coronavirinae; Coronaviridae; Nidovirales; positive-sense ssRNA Viruses; ssRNA Viruses; RNA Viruses; viruses; Homo; Hominidae; primates; mammals; vertebrates; Chordata; animals; eukaryotes; Latin America; America; South America; upper-middle income countries; very high Human Development Index countries; death rate; SARS-CoV-2; viral infections; clinical picture; disease progression; kidney disorders; nephropathy; renal diseases; critical care; lung diseases; bacterial infections; bacterioses; bacterium
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Collection:
Databases of international organizations
Database:
GIM
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
Language:
English
Journal:
Medicina
Year:
2021
Document Type:
Article
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