Abstract
Background: Acute kidney injury (AKI) is frequent in Coronavirus Infection Disease 2019 (COVID-19) patients. Factors associated with AKI in COVID-19 intensive care unit (ICU) patients and their outcomes have not been previously explored.
Methods: Prospective observational study of COVID-19 patients admitted to the ICUs of the Hospital Clínic of Barcelona (Spain), from March 25th to April 21st, 2020, who developed AKI stage 2 or higher (AKIN classification). The primary goal was to describe the characteristics of moderate-severe AKI of COVID-19 patients in an ICU context. As a secondary goal, we aimed to find independent predictors of AKI progression, Renal Replacement Therapy (RRT) requirement and mortality among these patients.
Results: During the study period, 52 out of 237 ICU patients, developed AKIN stage 2 or higher and were included in the study. A Sequential Organ Failure Assessment (SOFA) score at AKI diagnosis of 8 or higher was associated with RRT, OR 5.2, p 0.032. At the time of AKI diagnosis, patients had a worse liver profile and higher inflammation markers than at admission. Fifty per cent of the patients presented AKI progression from AKIN 2 to 3 and 28.85% required RRT. The use of corticosteroids in 69.2% of patients was associated with a reduced requirement of RRT, OR 0.13 (CI 95% 0.02-0.89), p 0.037. AKI was associated with high mortality (50%) and a longer hospital stay, median 35 vs 18 days (p 0.024).
Conclusions: The prevalence of moderate/severe AKI in COVID-19 patients admitted to the ICU is high and has a strong correlation with mortality and length of hospital stay.
Keywords: Acute kidney injury; COVID-19; Intensive care; Renal replacement therapy.
【저자키워드】 COVID-19, intensive care, Acute kidney injury, renal replacement therapy, 【초록키워드】 therapy, Mortality, Diagnosis, progression, outcome, ICU, Kidney injury, kidney, Prevalence, AKI, Characteristics, Prospective, Patient, Spain, ICU Patients, SOFA, correlation, assessment, Admission, liver, patients, COVID-19 patient, Barcelona, Hospital stay, RRT, Factor, failure, study period, high mortality, replacement, the patient, required, reduced, median, independent predictor, inflammation marker, moderate-severe, use of corticosteroid, 【제목키워드】 Critically ill, COVID-19 patient,