Outcomes of COVID-19 patients with acute kidney injury and longitudinal analysis of laboratory markers during the hospital stay: A multi-center retrospective cohort experience from Pakistan

Abstract

The frequency of acute kidney injury (AKI) in COVID-19 patients can be varied and related to worse outcomes in the disease population. AKI is common among hospitalized patients with COVID-19, particularly the ones needing critical care. This study was conducted in order to determine the outcomes of hospitalized patients with prolonged hospital stays who suffered from COVID-19 associated AKI. It was conducted as a multi-centered, retrospective, cohort study, and including all patients who were diagnosed on COVID-19 PCR. End-stage renal disease patients on hemodialysis were excluded. The cohort included 1069 patients, with 68% males, mean age of 56.21 years, and majority within 50 to 75 years age group (60%). Mean disease onset was 14.43 ± 7.44 days and hospital stay was 7.01 ± 5.78 days. About 62% of patients stayed in intensive care and 18% of them were on invasive ventilation. The mortality rate was 27%. Frequency of AKI was 42%, around 14% of them were resolving during hospital stay and other 28% worsened. The mortality rate was significantly higher with AKI (OR: 4.7, P < .001). Alongside AKI, concomitant liver dysfunction was also significantly contributing to mortality (OR: 2.5), apart from ICU stay (OR: 2.9), invasive ventilation (OR: 9.2), and renal replacement therapy (OR: 2.4). Certain laboratory markers were associated with AKI throughout in-hospital stay.

The Outcome of Left Ventricular Thrombosis in Patients with Coronavirus Disease 2019 Infection

“…Coronavirus disease 2019 patients are reported to have encountered acute kidney injury (AKI) with a prevalence rate of 0.5% to 35%, which is correlated with a worse prognosis in these patients (38). The frequency of AKI in COVID-19 patients can vary and is related to worse outcomes in the disease population (39). Five of our patients (22%) had presented with AKI, which was in line with previous studies.…”

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

“…[10][11][12][13][14] The local evidence also supports the considerably high burden of acute liver injury and acute kidney injury among COVID-19 patients with severe and prolonged disease. 15,16 This study did not find any statistical differences in the serum levels for most of the inflammatory biomarkers i.e., CRP, LDH, ferritin, and d-dimer based on differences in age, sex, types, and number of previous medical comorbidity, ICU mortality, and hospital mortality. This can be explained by the previous local evidence where the rise in biomarkers among hypoxic COVID-19 patients was later followed by a decline and high mortality among patients with invasive ventilation.…”

“… 10 - 14 The local evidence also supports the considerably high burden of acute liver injury and acute kidney injury among COVID-19 patients with severe and prolonged disease. 15 , 16 …”

Risk Factors and Outcome of Acute Kidney Injury in Critical COVID-19 patients in Karachi, Pakistan: A Single center, Retrospective study

“…[22][23][24] Patients in our population who had acute renal injury complication demonstrated severe outcomes and acute kidney injury was recognized as a predictor. 25,26 The limitation of our study was that it was a retrospective study and and low sample size. The effects of COVID-19 are felt strongly throughout the world, but surprisingly, rich countries were more severely impacted than developing ones.…”