Prognostic Factors in Patients with AKI and COVID-19

Prognostic Factors in Patients with AKI and COVID-19. ABSTRACT Background : Acute kidney injury is challenging in the context of the COVID-19 pandemic. Up to 30 % of critically ill COVID-19 pa tients develop AKI. Thus, it is imperative to determine what factors may predict the likelihood of these patients developing more severe and potentially life-threatening conditions. Objective : The aim of this study is to investigate the clinical and computed tomography features associated with poor prognostic factors in COVID-19 patients developing AKI. We also aimed to investigate chest CT score and its pattern in AKI patients in the COVID-19 setting. Materials and Methods : 415 patients with COVID-19 pneumonia were enrolled. 64 patients have been excluded due to a history of chronic kidney disorders. Finally, 351 patients, including 100 AKI cases and 251 non-AKI cases, were enrolled. The chest CT images and clinical data of them were reviewed and compared. The CT scores and the risk factors associated with disease severity were discussed. Results: Compared with the non-AKI group, the AKI patients had older ages and a higher incidence of certain comorbidities, such as hypertension and cardiovascular disorders. In AKI patients, the value of inflammatory markers, e.g., CRP, LDH, PCT, and Lactate level were significantly higher than those of the ordinary patients (P<0.05). In addition, the AKI patients showed higher incidences of lymphopenia (P=0.019) and leukocytosis (P=0.023). In the AKI group, the CT-scores were significantly higher than those of the non-AKI group (P < 0.001), and severe CT- scores were mainly associated with AKI. ROC analysis showed that 71.4 % sensitiv ity and 90 % specificity for CT scores higher than 13 in the AKI group. Out of all measured parameters, CT-score and the level of PCT, lactate, and WBC were the most reliable factors for predicting mortality in AKI patients. Conclusions: There are significant differences in clinical symp -toms, laboratory examinations, and CT manifestations between the AKI and non-AKI patients in the COVID-19 setting. Many factors are associated with the severity of the illness, which can help clinicians assess patients' prognosis.