Mogga Phanidhar, Venkatraman Shreevidya, Rajagopalan Urjitha, Rajagopalan Prashanth, Radhan Prabhu, Maithrayie Kumaresan, Padmanabhan Sivaraj, Murugan Swamikannu, Nagarajan Archana, Venkataraman Chandrasekaran, Mathew Milly, Abraham Georgi, Lesley Nancy
Department of Nephrology, MGM Healthcare, Chennai, Tamil Nadu, India.
Department of Internal Medicine, MGM Healthcare, Chennai, Tamil Nadu, India.
Indian J Nephrol. 2022 Jul-Aug;32(4):348-358. doi: 10.4103/ijn.ijn_350_21. Epub 2022 Jul 12.
There is a scarcity of information on the incidence and outcomes of acute kidney injury (AKI) in COVID-19 patients in India. Therefore, we analyzed the correlation of AKI risk factors, ventilatory support, and renal replacement therapy and compared the outcomes of first and second COVID-19 waves in this tertiary care center.
We retrospectively analyzed the patients' medical records with a positive RT-PCR for COVID-19 between July 2020 and May 2021. We looked at the clinical outcomes of the first and second COVID-19 waves and documented the frequency, risk factors for AKI, and the relationship between AKI and in-hospital mortality. Univariate and multivariate binomial logistic regression yielded odds ratios for the risk variables of AKI. Risk differences and age-adjusted odds ratios, as well as 99.5% confidence intervals, were used to compare COVID-19 outcomes between the first and second waves.
Of the 1260 hospitalized patients with COVID-19, 86 (6.8%) presented with AKI and 8 (0.7%) patients required dialysis. The most common comorbidity was diabetes mellitus (55.2%), hypertension (42.1%), hypothyroidism (11.3%), and coronary artery disease (8.1%). A total of 229 (18.17%) patients were admitted to ICU, 574 (45.5%) received ventilation, and 26 (2.0%) required mechanical ventilation.The incidence of in-hospital death in the patients with AKI as per the stage from 1 to 3 was 9 (15.8%), 7 (35%), and 5 (55.6%), respectively.Compared to the first wave, the second wave cohort had a lower risk of AKI (adj OR: 0.426; CI: 0.232-0.782) and mortality (adj OR: 0.252; CI: 0.090-0.707).
In our study, AKI prevalence was 6.8%, the need for ventilation was 45.5%, ECMO 0.2%, and the mortality rate 2.9%. Second wave of COVID-19 exhibits improved clinical outcomes compared to the first wave.
关于印度新冠肺炎患者急性肾损伤（AKI）的发病率和预后的信息匮乏。因此，我们分析了AKI危险因素、通气支持和肾脏替代治疗之间的相关性，并比较了该三级护理中心第一波和第二波新冠肺炎疫情的预后情况。
我们回顾性分析了2020年7月至2021年5月期间RT-PCR检测新冠病毒呈阳性的患者的病历。我们观察了第一波和第二波新冠肺炎疫情的临床预后情况，记录了AKI的发生率、危险因素以及AKI与院内死亡率之间的关系。单因素和多因素二项逻辑回归得出了AKI风险变量的比值比。风险差异、年龄调整后的比值比以及99.5%置信区间用于比较第一波和第二波新冠肺炎疫情的预后情况。
在1260例住院的新冠肺炎患者中，86例（6.8%）出现AKI，8例（0.7%）患者需要透析。最常见的合并症是糖尿病（55.2%）、高血压（42.1%）、甲状腺功能减退（11.3%）和冠状动脉疾病（8.1%）。共有229例（18.17%）患者入住重症监护病房，574例（45.5%）接受了通气治疗，26例（2.0%）需要机械通气。根据1至3期，AKI患者的院内死亡率分别为9例（15.8%）、7例（35%）和5例（55.6%）。与第一波相比，第二波队列发生AKI的风险较低（调整后的比值比：0.426；置信区间：0.232-0.782），死亡率也较低（调整后的比值比：0.252；置信区间：0.090-0.707）。
在我们的研究中，AKI患病率为6.8%，通气需求为45.5%，体外膜肺氧合（ECMO）为0.2%，死亡率为2.9%。与第一波相比，第二波新冠肺炎疫情的临床预后有所改善。
