Determinants of Mortality in Patients with Acute Kidney Injury Caused by Coronavirus Disease 2019 Infection in a Tertiary Care Hospital of South India

Abstract

Acute kidney injury (AKI) is common in coronavirus disease 2019 (COVID-19), and its severity is linked to the adverse outcomes of multiorgan involvement. We attempted to assess the clinical outcomes and determinants of mortality in patients admitted to our COVID-19 care center from May to November 2020 who developed AKI through a retrospective examination of their case records. The data of those who developed AKI were analyzed for their clinical parameters, clinical presentation, history, laboratory parameters, urine output measurements, requirements for dialysis, treatment, and treatment outcomes (discharge or death). These outcomes were correlated to the comorbidities, laboratory parameters, the Kidney Disease Improving Global Outcomes (KDIGO) AKI stage, sequential organ failure assessment score, and need for dialysis or renal replacement therapy. Of 1890 patients admitted, 132 (6.98%) patients developed AKI. Of 450 deaths from all causes, 67 (14%) were in AKI patients. There were 100 (75.8%) males and 32 (24.8%) females. The mean age was 62.05 ± 11.48 years. The median duration of stay was 7 days (interquartile range: 4––11.75 days). The number of patients in AKI Stages 1, 2, and 3 was 1 (0.75%), 64 (48.48%), and 67 (50.75%), respectively. The most common symptoms were breathlessness (85.6%), fever (84.5%), myalgia (81.19%), and weakness (76.5%). Multivariate analysis showed that the determinants of mortality were a partial pressure of oxygen saturation (pO2) of <75% and of 76%-85% compared with a pO2 of >85%, not receiving remdesivir, and KDIGO Stage >2.