A Tertiary Care Centre Experience of COVID-19-Associated AKI During the First and Second Waves of the Pandemic

ABSTRACT

Background: There is a scarcity of information on the incidence and outcomes of acute kidney injury in COVID-19 patients in India. Therefore, we analysed the correlation of AKI risk factors and compared the outcomes of the first and second COVID-19 waves in a tertiary care centre. Method(s) *Single centre retrospective analysis *Patients who tested positive for COVID-19 between July 2020 and May 2021, with serum creatinine levels measured on admission (n= 1260). *AKI was defined according to the KDIGO clinical practice guidelines. *Multivariate binomial logistic regression yielded odds ratios for risk variables of AKI. *Age-adjusted odds ratios(OR) were used to compare COVID-19 outcomes between the first and second waves. Result(s) Baseline characteristics *Median Age= 56 (IQR 47-66) *Population with diabetes-55.2% *Population with hypertension-42.11% All AKI (n=86) *Stage 1 (n=57) *Stage 2 (n=20) *Stage 3 (n=9) Risk factors for AKI *Diabetes OR 1.9 (1.2 - 3.1) *Hypertension OR 3.2 (2.0 - 5.2) *C-reactive protein >= 10 mg/dl, OR 3.6 (1.6 - 8.0). *D-dimer >= 250 pg/ml, OR 4.2 (2.5 - 6.8). *Need for ventilation OR 3.06 (1.8 - 4.9) Comparison of COVID -19 outcomes: Compared to the first wave, the second wave cohort had lower risk for *Acute kidney injury (adj OR 0.4;CI 0.2-0.7) *Mortality (adj OR 0.2;CI 0.09-0.7) *Invasive mechanical ventilation (adj OR 0.2;CI 0.06 - 0.8) *Length of ICU stay > 5days (adj OR 0.4;CI 0.2 - 0.7) Conclusion(s) In our retrospective study, AKI prevalence was 6.8%, and the mortality rate of 2.9%. Our analysis shows that the second wave of COVID -19 exhibits improved clinical outcomes compared to the first wave. (Table Presented).