Abstract Background Early reports indicate that AKI is common during COVID-19 infection. Different mortality rates of AKI due to SARS-CoV-2 have been reported, based on the degree of organic dysfunction and varying from public to private hospitals. However, there is a lack of data about AKI among critically ill patients with COVID-19. Methods We conducted a multicenter cohort study of 424 critically ill adults with severe acute respiratory syndrome (SARS) and AKI, both associated with SARS-CoV-2, admitted to six public ICUs in Brazil. We used multivariable logistic regression to identify risk factors for AKI severity and in-hospital mortality. Results The average age was 66.42 ± 13.79 years, 90.3% were on mechanical ventilation (MV), 76.6% were at KDIGO stage 3, and 79% underwent hemodialysis. The overall mortality was 90.1%. We found a higher frequency of dialysis (82.7% versus 45.2%), MV (95% versus 47.6%), vasopressors (81.2% versus 35.7%) ( p < 0.001) and severe AKI (79.3% versus 52.4%; p = 0.002) in nonsurvivors. MV, vasopressors, dialysis, sepsis-associated AKI, and death ( p < 0.001) were more frequent in KDIGO 3. Logistic regression for death demonstrated an association with MV (OR = 8.44; CI 3.43–20.74) and vasopressors (OR = 2.93; CI 1.28–6.71; p < 0.001). Severe AKI and dialysis need were not independent risk factors for death. MV (OR = 2.60; CI 1.23–5.45) and vasopressors (OR = 1.95; CI 1.12–3.99) were also independent risk factors for KDIGO 3 ( p < 0.001). Conclusion Critically ill patients with SARS and AKI due to COVID-19 had high mortality in this cohort. Mortality was largely determined by the need for mechanical ventilation and vasopressors rather than AKI severity.
【저자키워드】 COVID-19, Critical care, Acute kidney injury, dialysis, renal failure, mortality risk, 【초록키워드】 Brazil, SARS-CoV-2, mechanical ventilation, severity, risk factor, ICU, hospitals, Cohort, Hemodialysis, AKI, Critically ill, COVID-19 infection, death, age, mortality rate, in-hospital mortality, association, Frequency, Critically ill patient, dysfunction, Vasopressor, acute respiratory syndrome, overall mortality, multivariable logistic regression, nonsurvivors, average, high mortality, vasopressors, independent risk factor, KDIGO, multicenter cohort study, Result, identify, lack, reported, conducted, demonstrated, on mechanical ventilation, with COVID-19, 【제목키워드】 Critically ill patient,