Acute Kidney Injury among Hospital-Admitted COVID-19 Patients: A Study from Jordan

Oweis, Ashraf O; Alshelleh, Sameeha A; Hawasly, Lubna; Alsabbagh, Ghalia; Alzoubi, Karem H.

doi:10.2147/ijgm.s360834

Cited by 11 publications

(11 citation statements)

References 40 publications

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“…Patients who contracted COVID-19 with underlying comorbidities were associated with poorer outcomes [41,42]. In our cohort, patients with either diabetes or hypertension were independent predictors for AKI, and our findings were supported by other studies [43,44]. In addition, ferritin, an acute phase reactant, tends to be elevated in inflammatory conditions, including infections.…”

Section: Discussionsupporting

confidence: 86%

A study of hospitalized COVID-19 patients with AKI in a setting of multiracial developing country

Ooi,

Ng,

Sthaneshwar

et al. 2024

BMC Nephrol

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Background The commonest indication for hospitalization in COVID-19 patients is hypoxemia or severe respiratory symptoms. However, COVID-19 disease may result in extrapulmonary complications including kidney-related pathology. The reported incidence of renal involvement related to COVID infection varies based on geographical location. Objective This study aimed to assess the incidence rate of AKI in hospitalized COVID-19 patients and identify risk factors and prognostic predictors. Method In this retrospective study, we recruited hospitalized COVID-19 patients from January 2021 until June 2021 at the University Malaya Medical Center. The inclusion criteria were hospitalized for ≥ 48 h with confirmed COVID-19 infection and at least 18 years old. Patient demographic and clinical data were collected from electronic medical records. The staging of AKI was based on criteria as per KDIGO guidelines. Results One thousand five hundred twenty-nine COVID patients fulfilled the inclusion criteria with a male-to-female ratio of 759 (49.6%) to 770 (50.3%). The median age was 55 (IQR: 36–66). 500 patients (32.7%) had diabetes, 621 (40.6%) had hypertension, and 5.6% (n = 85) had pre-existing chronic kidney disease (CKD). The incidence rate of AKI was 21.1% (n = 323). The percentage of COVID patients in different AKI stages of 1,2 and 3 were 16.3%, 2.1%, and 2.7%, respectively. Fifteen hospitalized patients (0.98%) required renal replacement therapy. 58.8% (n = 190) of AKI group had complete recovery of kidney function. Demographic factors included age (p < 0.001), diabetes (p < 0.001), hypertension (p < 0.012), CKD (p < 0.001), and vaccination status (p = 0.042) were associated with an increased risk of developing AKI. We found that the AKI cohort had statistically significant lower platelet counts and higher ferritin levels than the non-AKI cohort. AKI is a risk predictor of prolonged hospitalization (p < 0.001) and higher mortality rates (P < 0.001). Conclusion AKI is a common clinical complication among hospitalized COVID-19 patients. The etiology of AKI is multifactorial and may have an adverse impact on patient morbidity and mortality.

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Section: Discussionsupporting

confidence: 86%

A study of hospitalized COVID-19 patients with AKI in a setting of multiracial developing country

Ooi,

Ng,

Sthaneshwar

et al. 2024

BMC Nephrol

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“…[21][22][23] This study didn't observe any significant association between d-dimer and kidney injury which is contrary to the previous evidence; however, this can be explained by the differences in the study population as well as the severity of disease. 20 In addition, patients who had ICU stay of > three days or received mechanical ventilation for > two days were also found to have significantly higher median levels of d-dimer than those patients with ICU stay of ≤ three or who received mechanical ventilation for ± two days. This finding is in line with previous evidence supporting the influence of high d-dimer levels at third day of hospital admission in predicting hospital mortality among COVID-19 patients.…”

Section: Discussionmentioning

confidence: 92%

“…Previous studies have been reporting a positive association of high levels of d-dimer with the development of kidney injury, liver injury, as well as COVID-19 associated mortality. 15 - 20 However, previously published literature shows mixed evidence regarding the association of d-dimer levels with myocardial infarction and its severity among COVID-19 patients hence requires further research. 21 - 23 This study didn’t observe any significant association between d-dimer and kidney injury which is contrary to the previous evidence; however, this can be explained by the differences in the study population as well as the severity of disease.…”

Section: Discussionmentioning

confidence: 99%

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Frequency of extra pulmonary complications in critically ill COVID-19 patients and their association with inflammatory markers and hypoxia: Retrospective analysis at a tertiary care hospital in Karachi, Pakistan

Hanif,

Sohaib,

Talha

et al. 2023

Pak J Med Sci

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Background and Objective: This study aimed to determine the incidence of extra pulmonary complications among critically ill COVID-19 patients requiring invasive mechanical ventilation and association of these complications with various inflammatory markers and degree of hypoxia. Methods: A retrospective cohort study was conducted among 173 adults in Karachi having COVID-19 and were admitted to ICU in a tertiary care private hospital between August 2020 to July 2021. Results: The median age of patients included in the analysis was 61 years (IQR; 16). Acute kidney injury, septic shock, cardiac injury, and electrolytes imbalance were the most frequent extra pulmonary complications with proportion of 65.3% (n=113), 63.6% (n=110), 61.8% (n=107) and 33.5% (n=58). Statistically significant differences in the median serum levels of ferritin were observed among male versus female, critically ill covid patients with and without ICU mortality as well as patients with and without hospital mortality (p-value <0.05). Significantly higher serum levels of d-dimer were noted among patients who developed acute liver injury or NSTEMI, or had ICU stay of > 3 days or received mechanical ventilation for >2 days. Conclusion: Acute kidney injury, septic shock, cardiac injury, and electrolytes imbalance were the most common extra pulmonary complications among mechanically ventilated COVID-19 patients with ARDS. Higher serum d-dimer levels were associated with acute liver injury, NSTEMI, ICU stay longer >3 days and invasive mechanical ventilation >2 days. Higher serum ferritin levels are associated with male sex and serve as an important predictor of ICU as well as hospital mortality. doi: https://doi.org/10.12669/pjms.39.6.7380 How to cite this: Hanif S, Sohaib M, Talha S, Rayani A. Frequency of extra pulmonary complications in critically ill COVID-19 patients and their association with inflammatory markers and hypoxia: Retrospective analysis at a tertiary care hospital in Karachi, Pakistan. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7380 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…AKI is significantly influenced by a number of factors, including inflammatory response linked to immunologic injury, cardio-renal dysfunction, cell invasion, and hypovolemia. Numerous other factors are also being studied (6,7).…”

Section: Introductionmentioning

confidence: 99%

Predictors of Mortality of Covid-19 Infected Patients With Acute Kidney Injury

Nariswari,

Tandarto,

Tjempakasari

2023

JUMMEC

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Introduction: Coronavirus disease 2019 (COVID-19) is a condition brought on by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) where this virus is highly contagious. In several studies, acute kidney injury was associated with the cause of death. This study aimed to analyze what factors played a role as predictors of mortality in COVID-19 patients who experienced acute kidney injury. Method: This study used a one-center retrospective cohort method where the study was conducted at Dr. Soetomo General Academic Teaching Hospital, Surabaya, Indonesia. Statistical analysis of multivariate logistic regression was performed, and the results were presented in the form of an odds ratio (OR), with a p-value considered significant < 0.05 and a 95% confidence interval. Results: A total of 498 COVID-19 patients with acute kidney injury were included in this study. Our research found that 153 subjects (30.7%) died. The results of multivariate logistic regression analysis showed that the largest OR value was the D-dimer value variable, namely 2.102 (95% CI: 1.361-3.247), which means that COVID-19 patients with acute kidney injury who have a D-dimer value of ≥ 1.2 mg/L have the possibility of experiencing mortality within 30 days was 2.1 times greater than in patients with D-dimer values < 1.2 mg/L. The next variables were albumin value < 3.5 g/dL (OR 2.015, 95% CI: 0.992-4.091), history of hypertension (OR 2.003, 95% CI: 1.343-2.988). Conclusion: Our study found that a history of hypertension, higher than normal D-dimer levels, and hypoalbuminemia were predictors of mortality in patients with acute kidney injury who were infected with COVID-19.

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Acute Kidney Injury among Hospital-Admitted COVID-19 Patients: A Study from Jordan

Cited by 11 publications

References 40 publications

A study of hospitalized COVID-19 patients with AKI in a setting of multiracial developing country

A study of hospitalized COVID-19 patients with AKI in a setting of multiracial developing country

Frequency of extra pulmonary complications in critically ill COVID-19 patients and their association with inflammatory markers and hypoxia: Retrospective analysis at a tertiary care hospital in Karachi, Pakistan

Predictors of Mortality of Covid-19 Infected Patients With Acute Kidney Injury

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