Factors affecting outcome in reverse transcriptase-polymerase chain reaction-positive lassa fever patients with acute kidney injury: A retrospective analysis

Abstract

Lassa fever (LF) is a viral haemorrhagic fever (VHF) endemic in the West African sub-region. It causes regular outbreaks with a significant case fatality rate (CFR). An estimated 100,000–300,000 people are infected with Lassa fever virus (LASV) every year in West Africa. Acute kidney injury (AKI) is a recognized complication of LF and may contribute significantly to the high CFR. We retrospectively studied 187 reverse transcriptase-polymerase chain reaction (RT-PCR)-positive LF patients admitted and managed at the infectious diseases centre of Abubakar Tafawa Balewa University Teaching (ATBUTH), Bauchi, to shed more light on the effect of AKI on the outcome. Materials and Methods: The case files of 187 RT-PCR-positive LF patients admitted between January 2018 and December 2020 at the infectious disease centre of ATBUTH were retrieved. We performed parametric and nonparametric statistical analyses including logistic regression to determine factors associated with poor outcomes. Results: During the study period, 187 RT-PCR-positive LF patients were admitted and treated in our centre; 130 (69.5%) were males and 27 (30.5%) were females. The mean age of presentation was 37.3 ± 15.5 years, and nearly all the patients presented with fevers of varying duration. There were 53 deaths with a CFR of 28.3%. More than 2/3 of the deaths were among the age group of 18–47 years. AKI was observed in 12.8% of the patients whose mean age was 37.17 ± 13.13 years. AKI was significantly associated with poor outcomes. Raised systolic blood pressure (odds ratio [OR] = 1.042, 95% confidence interval [CI] 1.008–1.076, P = 0.014) and serum creatinine (OR = 0.952, 95% CI 0.904–1.002, P = 0.000) were found as significant risk factors for developing AKI. Conclusion: Lassa fever is a multisystemic illness. Kidney involvement occur early and can lead to acute kidney injury with its attendant complications. Our study highlighted the significance of AKI as a contributor to poor outcome among patients with Lassa Fever infection.