COVID-19 and acute kidney injury presentation; stages and prognosis

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) can present with acute kidney injury (AKI). Although the rate of AKI among these patients is not high, their outcome could be much worse than the other patients. Serum creatinine rise along with other laboratory findings may help as a clinical predictor of COVID-19 disease prognosis. Objectives: We aimed to evaluate the incidence and possible predictors of AKI occurrence and its outcome during the COVID-19 pandemic. Patients and Methods: In a retrospective observational study of 946 hospital-admitted patients with confirmed COVID-19 between March 20, 2020 and May 9, 2020, we described AKI incidence and its stages along with their association with demographic data, comorbidities, habitual and past-medical history, and laboratory findings using STATA version 14. Results: The mean age of participants was 55.6 (±18.7) years of which 60.4% were male. The most and least frequent underlying diseases were hypertension and chronic liver disease, 20.1% and 1.5%, respectively. Among patients with AKI, 45.9% had a higher age mean and female sex was more prevalent. In addition, hypertension, ischemic heart disease, diabetes, and chronic renal disease were more common in patients with AKI compared to patients without AKI. Moreover, AKI patients had lower oxygen saturation and mean levels of lymphocytes and higher mean levels of LDH and CKMB in comparison with no AKI group on admission. Overall, 80% of the patients were discharged (i.e. alive), of which 63.7% were non-severe patients and 19.4% of the patients expired during hospitalization. Conclusion: Comorbidities were more prevalent among AKI groups. Female and older patients were more prone to AKI during COVID-19 progression. The level of CK-MB was also higher in AKI group, suggesting probable cardiac injury. Lymphopenia and leukocytosis may be poor-prognostic factors for both AKI and COVID-19.