Ramatillah Diana Laila, Michael Michael, Khan Kashifullah, Natasya Nia, Sinaga Elizabeth, Hartuti Silvy, Fajriani Nuzul, Farrukh Muhammad Junaid, Gan Siew Hua
Faculty of Pharmacy, Universitas 17 Agustus 1945 Jakarta, North Jakarta 14350, Indonesia.
Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail 2440, Saudi Arabia.
Vaccines (Basel). 2023 Feb 13;11(2):433. doi: 10.3390/vaccines11020433.
In this study, we aim to evaluate the factors that may contribute to the development of chronic kidney disease following COVID-19 infection among hospitalized patients in two private hospitals in Jakarta, Indonesia. This is a retrospective cohort study between March 2020 and September 2021. Patient selection was conducted with a convenience sampling. All patients (n = 378) meeting the inclusion criteria during the study period were enrolled. Various sociodemographic, laboratory test, and diagnostic parameters were measured before the determination of their correlation with the outcome of COVID-19 infection. In this study, all pre-vaccinated patients with COVID-19 had no history of chronic kidney disease (CKD) prior to hospital admission. From this number, approximately 75.7% of the patients developed CKD following COVID-19 diagnosis. Overall, significant correlations were established between the clinical outcome and the CKD status ( = 0.001). Interestingly, there was a significant correlation between serum creatinine level, glomerular filtration rate (GFR), and CKD ( < 0.0001). Oxygen saturation ( = 0.03), admission to the intensive care unit (ICU) ( < 0.0001), and sepsis ( = 0.005) were factors that were significantly correlated with CKD status. Additionally, the type of antibiotic agent used was significantly correlated with CKD ( = 0.011). While 82.1% of patients with CKD survived, the survival rate worsened if the patients had complications from hyperuricemia ( = 0.010). The patients who received levofloxacin and ceftriaxone had the highest (100%) survival rate after approximately 50 days of treatment. The patients who received the antiviral agent combination isoprinosine + oseltamivir + ivermectin fared better (100%) as compared to those who received isoprinosine + favipiravir (8%). Factors, such as hyperuricemia and the antibiotic agent used, contributed to CKD following COVID-19 hospitalization. Interestingly, the patients who received levofloxacin + ceftriaxone and the patients without sepsis fared the best. Overall, patients who develop CKD following COVID-19 hospitalization have a low survival rate.
在本研究中,我们旨在评估印度尼西亚雅加达两家私立医院中,新冠病毒感染后可能导致住院患者发生慢性肾脏病的因素。这是一项2020年3月至2021年9月间的回顾性队列研究。采用便利抽样法进行患者选择。纳入研究期间所有符合纳入标准的患者(n = 378)。在确定各项社会人口统计学、实验室检查及诊断参数与新冠病毒感染结局的相关性之前,对这些参数进行了测量。在本研究中,所有新冠病毒感染前未接种疫苗的患者在入院前均无慢性肾脏病(CKD)病史。其中,约75.7%的患者在新冠病毒感染诊断后发生了CKD。总体而言,临床结局与CKD状态之间存在显著相关性(P = 0.001)。有趣的是,血清肌酐水平、肾小球滤过率(GFR)与CKD之间存在显著相关性(P < 0.0001)。血氧饱和度(P = 0.03)、入住重症监护病房(ICU)(P < 0.0001)和脓毒症(P = 0.005)是与CKD状态显著相关的因素。此外,所用抗生素类型与CKD显著相关(P = 0.011)。虽然82.1%的CKD患者存活,但如果患者出现高尿酸血症并发症,生存率会降低(P = 0.010)。接受左氧氟沙星和头孢曲松治疗的患者在治疗约50天后生存率最高(100%)。与接受异肌苷+法匹拉韦的患者(8%)相比,接受抗病毒药物组合异肌苷+奥司他韦+伊维菌素的患者预后更好(100%)。高尿酸血症和所用抗生素等因素在新冠病毒感染住院后导致了CKD。有趣的是,接受左氧氟沙星+头孢曲松治疗的患者和未发生脓毒症的患者预后最佳。总体而言,新冠病毒感染住院后发生CKD的患者生存率较低。