Aki in Patients Hospitalised with Covid-19 Infection

ABSTRACT

BACKGROUND: COVID-19 is primarily a respiratory tract infection, but it should be regarded as a systemic disease involving multiple systems including kidneys. The incidence of acute kidney injury in hospitalized patients with COVID-19 varies ranging from 10% in Indian subcontinent to 37-45% from Western studies. AIM OF THE STUDY To study the incidence of acute kidney injury in patients hospitalized with COVID-19 infection. To study the risk factors for acute kidney injury in patients with COVID-19 infections. To study the impact of acute kidney injury on the outcomes in COVID19 infected patients. METHOD(S) All hospitalized COVID-19-infected patients diagnosed by RT-PCR and rapid antigen tests were included. Patients with structural abnormalities of the urinary tract renal transplant recipients patients on maintenance hemodialysis those with incomplete records and outpatients were excluded from the study. Variables analyzed included age, gender, comorbidities, vital signs S. Creatinine values. Urinary abnormalities mortality need for hemodialysis recovery of renal function and duration of hospital stay. RESULT(S) Out of the 400 patients in our study, 50 patients (12.5%) had acute kidney injury. Of theses 50 patients, 27 patients had acute kidney injury stage 1, seven had stage 2, and 16 had stage 3. There were 31 males and majority (41 out of 50 patients) were above 60 years of age. Diabetes mellitus was present in 45 out of 50 patients, 42 patients had systemic hypertension, 30 had coronary artery disease, and 16 had bronchial asthma. Thirty-six out of 50 patients had COVID-19 category B and 14 belonged to COVID-19 category C. Urinary abnormalities included albuminuria (42 patients), microscopic hematuria (16 patients), pyuria (21 patients) and normal in 3 patients. Most common urinary abnormality among the AKI group was proteinuria (84%), whereas in non-AKI group urine was bland in majority of cases. Hemodialysis was needed for 16 patients. Thirteen patients required vasopressor support, and 12 patients required ventilatory support. Twenty-nine patients had complete recovery, and 10 patients had partial recovery of renal functions and eleven patients expired (22% of those with AKI);the mortality in the non-AKI group was 6.5%. All those who died had AKI stage 3. CONCLUSION(S) Among COVID-19-infected patients, 12.5% had acute kidney injury with majority in AKI stage 1 (54%). Majority of the patients were males and elderly (>60 years). Most common comorbidity was diabetes mellitus, followed by systemic hypertension and coronary artery disease. Majority of patients belonged to COVID-19 category B (72%). Most common urinary abnormality was proteinuria (84%). Need for vasopressor support, duration of ICU stay, hospital stay, and mortality were more in the AKI group.