Department of Internal Medicine, Adama Hospital Medical College, Adama, Ethiopia.
School of Medicine, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
BMC Nephrol. 2024 Mar 20;25(1):109. doi: 10.1186/s12882-024-03522-0.
Acute kidney injury (AKI) is a serious complication of the Corona Virus Disease of 2019 (COVID-19). However, data on its magnitude and risk factors among hospitalized patients in Ethiopia is limited. This study aimed to determine the magnitude of AKI and associated factors among patients admitted for severe COVID-19 pneumonia.
An institution-based retrospective cross-sectional study was conducted among 224 patients admitted to Jimma University Medical Center in Ethiopia for severe COVID-19 pneumonia from May 2020 to December 2021. Systematic random sampling was used to select study participants. Medical records were reviewed to extract sociodemographic, clinical, laboratory, therapeutic, and comorbidity data. Bivariable and multivariable logistic regressions were performed to examine factors associated with AKI. The magnitude of the association between the explanatory variables and AKI was estimated using an adjusted odds ratio (AOR) with a 95% confidence interval (CI), and significance was declared at a p-value of 0.05.
The magnitude of AKI was 42% (95% CI: 35.3-48.2%) in the study area. Mechanical ventilation, vasopressors, and antibiotics were required in 32.6, 3.7, and 97.7% of the patients, respectively. After adjusting for possible confounders, male sex (AOR 2.79, 95% CI: 1.3-6.5), fever (AOR 6.5, 95% CI: 2.7-15.6), hypoxemia (AOR 5.1, 95% CI: 1.4-18.9), comorbidities (AOR 2.8, 95% CI: 1.1-7.0), and severe anemia (AOR 10, 95% CI: 1.7-65.7) remained significantly associated with higher odds of AKI.
The burden of AKI among patients with severe COVID-19 pneumonia is high in our setting. Male sex, abnormal vital signs, chronic conditions, and anemia can identify individuals at increased risk and require close monitoring and prevention efforts.
急性肾损伤(AKI)是 2019 年冠状病毒病(COVID-19)的严重并发症。然而,关于其在埃塞俄比亚住院患者中的严重程度和危险因素的数据有限。本研究旨在确定因严重 COVID-19 肺炎住院患者中 AKI 的严重程度及其相关因素。
这是一项在 2020 年 5 月至 2021 年 12 月期间在埃塞俄比亚 Jimma 大学医学中心因严重 COVID-19 肺炎住院的 224 名患者中进行的基于机构的回顾性横断面研究。采用系统随机抽样选择研究对象。查阅病历,提取社会人口学、临床、实验室、治疗和合并症数据。采用双变量和多变量逻辑回归分析 AKI 的相关因素。使用调整后的优势比(AOR)及其 95%置信区间(CI)来估计解释变量与 AKI 之间的关联程度,并以 p 值<0.05 表示有统计学意义。
研究地区 AKI 的严重程度为 42%(95%CI:35.3-48.2%)。分别有 32.6%、3.7%和 97.7%的患者需要机械通气、血管加压药和抗生素。在调整了可能的混杂因素后,男性(AOR 2.79,95%CI:1.3-6.5)、发热(AOR 6.5,95%CI:2.7-15.6)、低氧血症(AOR 5.1,95%CI:1.4-18.9)、合并症(AOR 2.8,95%CI:1.1-7.0)和严重贫血(AOR 10,95%CI:1.7-65.7)与 AKI 的高风险显著相关。
在我们的研究环境中,严重 COVID-19 肺炎患者中 AKI 的负担很高。男性、异常生命体征、慢性疾病和贫血可以识别出风险增加的个体,需要密切监测和预防。