Publication: Incidence, Clinical Characteristics and Outcomes Associated with Acute Kidney Injury in Patients Hospitalized with COVID-19
Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Health Research Council
Abstract
Background: Acute kidney Injury associated with Coronavirus disease COVID-19 appeared to negatively influence clinical outcomes and is found to be associated with significant risk of death. This retrospective study aimed to describe the incidence of Acute Kidney Injury, its associations with clinical characteristics and outcomes among COVID-19 patients in Sukraraj Tropical and Infectious Disease Hospital, a tertiary infectious disease hospital in Nepal.
Methods: A cross-sectional study was done where. Medical and lab records of reverse transcriptase Polymerase chain reaction positive COVID-19 inpatients, admitted between April 2021 to July 2021 were reviewed. It represented the second wave of wave of coronavirus pandemic caused by the delta strain. Patients aged less than 18 years, pregnant females and patients with known chronic kidney disease were excluded
Results: Of 393 admissions, 83 (21.1%) patients developed Acute Kidney Injury. Characteristics found to have significant association with development of AKI was age (p <0.001), multiple co morbidities (2 or more) (p <0.001), use of mechanical ventilation (p <0.001), lymphopenia (p<0.001), Neutrophil to Lymphocyte Ratio (p =0.001) and d-dimer levels (p <0.001). Mortality was found to be significantly higher in COVID-19 patients with AKI compared to COVID-19 patients without AKI ((36.14% vs 15.8%, p value <0.01)). The median duration of hospital stay for patients with AKI was higher than for patients without AKI (10 days vs 6 days,p <0.01).
Conclusions: AKI develops in a sizeable percentage of patients with COVID-19 and is significantly associated with increasing age, multiple comorbidities, increased biomarkers, use of mechanical ventilation and is associated with poor outcome in terms of mortality and morbidity.
Keywords: AKI; COVID-19; Nepal; outcomes.
Description
Sanjay Shrestha
Department of Internal Medicine, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
Kijan Maharjan
Department of Internal Medicine, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
Milan Bajracharya
Department of Internal Medicine, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
Bimal Sharma Chalise
Department of Internal Medicine, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
Pujan Balla
Department of Anesthesiology, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
Shambhu Adhikari
Department of Anesthesiology, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
Soni Shrestha
Department of Microbiology, B.P.Koirala Institute of Health Sciences, Dharan, Nepal
Bishwodip Baral
Department of Internal Medicine, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
Jenish Neupane
Department of Internal Medicine, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
Manu Poudel
Department of Internal Medicine, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
Anup Bastola
Department of Tropical Medicine, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal