Pharmacotherapeutic Evaluation of Covid-19 Patients Suffering from Acute Kidney Injury

ABSTRACT

The risk of developing Acute Kidney Injury (AKI) increases manifold during severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Therefore, the aim of this study is to conduct a comprehensive pharmacotherapeutic evaluation of AKI in COVID-19 patients. A retrospective cohort study was conducted from July to August 2021 among COVID-19 patients admitted to the Institute of Kidney Diseases, Hayatabad Medical Complex hospital in Peshawar Pakistan. The data were extracted based on demographics, diagnosis, laboratory parameters, vital signs, and the treatment used during hospitalization. The association of independent variables was explored using parametric statistics such as regression analysis, one-way ANOVA, and Kruskal-Wallis. Data of N=595 COVID-19 patients with positive PCR tests as per pre-defined criteria were collected. It was observed that fever (n=575 [96.6%]), shortness of breath (n=570 [95.8%]), dry cough (n=449 [75.5%]) and body aches (n=129 [21.7%]) were some of the most common symptoms among the patients. Most of the patients were on a multi-drug regimen during hospitalization. Overall, it was observed that most of the laboratory variables significantly declined in COVID-19 patients with Stage III AKI. Mortality among the patients with AKI was 42% [0.418 [0.269 - 0.632], p=<0.001] as compared to non-AKI patients. There was a significant reduction in mortality by 96% (1.968 [1.277 - 3.033], p-0.002) with the use of intravenous dexamethasone. The prime goal of a clinician is to avoid the use of nephrotoxic drugs during hospitalization and maintain adequate oxygen saturation in order to avoid the development of AKI in COVID-19 patients.