Impact of acute kidney injury in COVID 19 infected patients

ABSTRACT

Background: Corona virus disease 2019 (covid-19) is a novel disease caused by a newly identified virus, severe acute respiratory syndrome corona virus 2 (sars-cov-2). The novel disease which begun in Wuhan, China in Dec 2019 was declared pandemic by world health organization on 11 march 2020. The most common reported reasons for intensive care unit admission for patients with severe corona virus disease 2019 (covid-19) are either hypoxemic respiratory failure leading to mechanical ventilation or hypotension requiring vasopressor support. Data on AKI are either lacking in this perspective, we emphasize that AKI can be a severe complication of covid-19 and highlight the importance of assessing, defining, and reporting the course of AKI in patients admitted in intensive care unit. Methods: This is a single centre retrospective observational study. 542 patients with real time-PCR and rapid antigen test confirmed COVID 19 infection admitted in KIMS intensive care unit, Hubballi were taken for study. Patients with chronic kidney disease were excluded from the study. Clinical examination and laboratory investigations including renal function test, liver function test, complete blood count, chest x-ray, d-dimer, ferritin, LDH, CRP was done for all the patients. Duration 1 year (2020 August -2021 July) Results: Out of 542 patients, 166 patients developed acute kidney injury accounting for 30.62%. 145 patients died (87.47) who had acute kidney injury. And 27 patients were discharged (12.6%) who recovered from acute kidney injury. Results: Among the patients who did not developed AKI(376) .300(79.81) died and 76(20.2) got discharged. The p value was 0.034 which was significant for increase in mortality among patients who developed AKI. The incidence of mortality among COVID patient admitted to KIMS ICU was 82.1%. Conclusion: The mortality was significantly higher in COVID patients developing AKI. So we can predict the outcome in COVID infected patients who develops acute kidney injury. AKI is one of manifestation in COVID patients due to tropism of corona virus to ace receptors present in kidney.