Aggravated sepsis, acute kidney injury, and microbiological resistance: Four year's pre-post COVID-19 outcome study.

Abstract

Introduction: The aim of our study was to compare the prevalence, etiology, and outcomes of sepsis and associated AKI in pre- and post-COVID-19 pandemic.

Methods: We conducted a retrospective observational analysis in 144 patients with sepsis and AKI, in two periods of time, 2 years before and after COVID-19 pandemic, with 2 years' washout period.

Results: The comparative analysis between the two periods demonstrated more severe forms of sepsis with septic shock dominating in the post pandemic period (5 (10%) vs 23 (25%), p = 0.037). According AKI staging we found AKI stage 3 more frequently present after pandemic and more patients needed dialysis in the post COVID-19 pandemic (35 (70%) vs 79 (84%), p = 0.04; 31 (62%) vs 78 (54%), p = 0.02; 16 (32%) vs 51% (54%), p = 0.018), respectively. Patients in post COVID-19 era survived less longer (22.66 ± 11.32 vs 17.132 ± 12.66, p = 0.021) with almost doubled risk for mortality HR: 1.977; 95% CI (1.127 ± 3.469), p = 0.018. Regarding causative agents' there was similar distribution in both periods, but the multiple antibiotic resistance index (MAR) was significantly higher in the post COVID-19 period for Staphylococcus coagulase negative (0.48 vs 0.62, p = 0.001).

Conclusion: Sepsis and associated AKI occurrence, morbidity and mortality are significantly higher in the post COVID-19 pandemic and the increased MAR of the germs can be one of the main reason for it.