tetano
Editor, Senior Moderator
Cir Cir
. 2024;92(5):626-632.
doi: 10.24875/CIRU.23000207. Acute kidney injury and mortality in patients with critical COVID-19 in Mexico: case-control study
Ivette Mata-Maqueda[SUP] 1 2 [/SUP], Juan C Solís-Sáinz[SUP] 2 [/SUP], Guadalupe Zaldivar-Lelo de Larrea[SUP] 2 [/SUP], Ernesto Deloya-Tomas[SUP] 1 2 3 [/SUP], Jorge López-Fermín[SUP] 1 2 3 [/SUP], Mª Guadalupe Olvera-Ramos[SUP] 1 2 3 [/SUP], Gabriela Castillo-Gutiérrez[SUP] 1 2 3 [/SUP], Jorge D Carrión-Moya[SUP] 1 2 3 [/SUP], Orlando R Pérez-Nieto[SUP] 1 2 3 [/SUP]
Affiliations
in English, Spanish
Objective: We aimed to test the association between acute kidney injury (AKI) and mortality in critically ill patients with Coronavirus disease 2019 (COVID-19).
Method: We conducted a single-center case-control study at the intensive care unit (ICU) of a second-level hospital in Mexico. We included 100 patients with critical COVID-19 from January to December 2021, and collected demographic characteristics, comorbidities, APACHE II, SOFA, NEWS2, and CO-RADS scores at admission, incidence of intrahospital complications, length of hospital and ICU stay, and duration of mechanical ventilation, among others.
Results: The median survival of deceased patients was 20 days. After multivariable logistic regression, the following variables were significantly associated to mortality: AKI (adjusted odds ratio [AOR] 6.64, 95% confidence intervals [CI] = 2.1-20.6, p = 0.001), age > 55 years (AOR 5.3, 95% CI = 1.5-18.1, p = 0.007), and arrhythmias (AOR 5.15, 95% CI = 1.3-19.2, p = 0.015). Median survival was shorter in patients with AKI (15 vs. 22 days, p = 0.043), as well as in patients with overweight/obesity (15 vs. 25 days, p = 0.026).
Conclusion: Our findings show that the development of AKI was the main risk factor associated with mortality in critical COVID-19 patients, while other factors such as older age and cardiac arrhythmias were also associated with this outcome. The management of patients with COVID-19 should include renal function screening and staging on admission to the Emergency Department.
Keywords: Acute kidney injury; COVID-19; Coronavirus disease 2019; Factores de riesgo; Lesión renal aguda; Mortalidad; Mortality; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2.
. 2024;92(5):626-632.
doi: 10.24875/CIRU.23000207. Acute kidney injury and mortality in patients with critical COVID-19 in Mexico: case-control study
Ivette Mata-Maqueda[SUP] 1 2 [/SUP], Juan C Solís-Sáinz[SUP] 2 [/SUP], Guadalupe Zaldivar-Lelo de Larrea[SUP] 2 [/SUP], Ernesto Deloya-Tomas[SUP] 1 2 3 [/SUP], Jorge López-Fermín[SUP] 1 2 3 [/SUP], Mª Guadalupe Olvera-Ramos[SUP] 1 2 3 [/SUP], Gabriela Castillo-Gutiérrez[SUP] 1 2 3 [/SUP], Jorge D Carrión-Moya[SUP] 1 2 3 [/SUP], Orlando R Pérez-Nieto[SUP] 1 2 3 [/SUP]
Affiliations
- PMID: 39401786
- DOI: 10.24875/CIRU.23000207
in English, Spanish
Objective: We aimed to test the association between acute kidney injury (AKI) and mortality in critically ill patients with Coronavirus disease 2019 (COVID-19).
Method: We conducted a single-center case-control study at the intensive care unit (ICU) of a second-level hospital in Mexico. We included 100 patients with critical COVID-19 from January to December 2021, and collected demographic characteristics, comorbidities, APACHE II, SOFA, NEWS2, and CO-RADS scores at admission, incidence of intrahospital complications, length of hospital and ICU stay, and duration of mechanical ventilation, among others.
Results: The median survival of deceased patients was 20 days. After multivariable logistic regression, the following variables were significantly associated to mortality: AKI (adjusted odds ratio [AOR] 6.64, 95% confidence intervals [CI] = 2.1-20.6, p = 0.001), age > 55 years (AOR 5.3, 95% CI = 1.5-18.1, p = 0.007), and arrhythmias (AOR 5.15, 95% CI = 1.3-19.2, p = 0.015). Median survival was shorter in patients with AKI (15 vs. 22 days, p = 0.043), as well as in patients with overweight/obesity (15 vs. 25 days, p = 0.026).
Conclusion: Our findings show that the development of AKI was the main risk factor associated with mortality in critical COVID-19 patients, while other factors such as older age and cardiac arrhythmias were also associated with this outcome. The management of patients with COVID-19 should include renal function screening and staging on admission to the Emergency Department.
Keywords: Acute kidney injury; COVID-19; Coronavirus disease 2019; Factores de riesgo; Lesión renal aguda; Mortalidad; Mortality; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2.