Acute Kidney Injury in Hospitalized Patients with COVID-19; evolution and mortality

Abstract

Background: COVID-19 infection is commonly complicated by acute kidney injury (AKI) in up to 60-80 % of patients, however, data characterizing the severity and evolution of AKI, are limited. The aim of this study was to describe risk factors associated with AKI severity, in-hospital mortality, and short-term renal recovery in hospitalized COVID-19 patients. Methods: A prospective cohort study that included Covid-19 patients, who developed AKI during hospitalization.Demographic, clinical, and laboratory data were recorded, and patients were followed up for 3 months. The study included 80 hospitalized COVID-19 patients who developed AKI. AKI stage 1, stage 2 and stage 3 occurred in 27(33.8%), 29(36.2%), and 24(30%) patients, respectively, whereas mortality was higher in stage 3 AKI (58.3%) compared to AKI stage 1(18.5%) and stage 2 (17.2%) p= 0.01. Of the 56 discharged patients, renal recovery occurred in AKI stage 1(100%), compared to AKI stage 2 (79%), and AKI stage 3 (50%). On multivariable analysis, age > 59 years, CKD, requiring dialysis, were associated with higher risk of mortality (Odd ratio: 1.9, 2.3, and 12.3, respectively). Conclusions: Stage 3 AKI patients had more ICU admissions, more patients required dialysis, less renal recovery, and higher mortality compared to AKI stage 1 and 2. CKD, age > 59 years, and requiring dialysis, were all independently associated with inhospital mortality. After 3 months follow up renal recovery was the role in mild kidney injury; stage 1 AKI compared to stage 2 and 3.