Abstract
Introduction: The kidney may be affected by coronavirus (COVID-19) in the setting of acute kidney injury (AKI). Data about AKI in intensive care unit (ICU) patients in Latin America are scarce. We aimed to evaluate the risk of AKI, dialysis (HD), and death in ICU COVID-19 patients in a Brazilian center.Methods: Analysis from medical records of COVID-19 patients in a Brazilian center.Results: A total of 95 patients were analyzed. There was male predominance (64.2%), median age: 64.9 years, and previous history of hypertension and diabetes in 51.6 and 27.4%, respectively. AKI was diagnosed in 54 (56.8%) patients, and 32 (59.2%) of them required HD. Mortality rate was 17.9%. AKI patients when compared with no-AKI were more frequently hypertensive/diabetic and more often needed organ support therapies. Workups depicted more anemia, lymphopenia, and higher levels of inflammatory markers and higher mortality. Comparing patients who had undergone death to survivors, they were older, more frequently diabetic, and had worse SAPS3 and SOFA scores and need for organ support therapies, AKI, and HD. Multinomial logistic regression revealed that hypertension (p = 0.018) and mechanical ventilation (p = 0.002) were associated with AKI; hypertension (p = 0.002), mechanical ventilation (p = 0.008), and use of vasopressor (p = 0.027) to HD patients; and age >65 years (p = 0.03) and AKI (p = 0.04) were risk factors for death.Conclusions: AKI was a common complication of ICU COVID-19 patients, and it was more frequent in patients with hypertension and need of organ support therapies. As well as age >65 years, AKI was an independent risk factor for death.
Highlights
The kidney may be affected by coronavirus (COVID-19) in the setting of acute kidney injury (AKI)
Brazil is the most populated country in Latin America and was the first place to confirm a case on the continent on February 25, 2020, in the city of São Paulo [7]
Several kidney problems associated with COVID have been previously described
Summary
The kidney may be affected by coronavirus (COVID-19) in the setting of acute kidney injury (AKI). Data about AKI in intensive care unit (ICU) patients in Latin America are scarce. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified by January 7, 2020, and the disease has since been named COVID-19. It was declared a pandemic in March 2020, affecting nearly every country. The initial clinical case series from China largely comprises hospitalized patients with severe pneumonia. Brazil is the most populated country in Latin America and was the first place to confirm a case on the continent on February 25, 2020, in the city of São Paulo [7]. The number of people affected by the disease is growing, and Brazil has become, at the moment, the third country in the world in the number of total cases [8]
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