Kumthekar Girish V, Nagarkar Manasi S, Purandare Veena, Shukla Sharvari, Yeravdekar Rajiv
Nephrology, Symbiosis Medical College for Women, Symbiosis University Hospital and Research Centre, Symbiosis International University (SIU), Pune, IND.
Medicine, Symbiosis Medical College for Women, Symbiosis University Hospital and Research Centre, Symbiosis International University (SIU), Pune, IND.
Cureus. 2024 Apr 7;16(4):e57763. doi: 10.7759/cureus.57763. eCollection 2024 Apr.
Introduction Acute kidney injury (AKI) develops in 20-70% of patients with COVID-19. AKI is a syndromic diagnosis with multiple causes and outcomes. This cross-sectional study explored different outcomes of AKI in patients admitted with COVID-19. Material and methods It was a cross-sectional and descriptive study carried out in a tertiary care teaching hospital in Western Maharashtra for two months (May to June 2020). We collected clinical and laboratory data of 456 inpatients admitted with COVID-19 over two consecutive months. We excluded patients already on dialysis upon arrival at the hospital. It predominantly consists of patients who developed AKI during their stay in the hospital. Result C-reactive protein (CRP) was elevated in patients with COVID-19 associated with AKI (COVAKI) (78.87) but was statistically significant (p<0.003). Ferritin was elevated significantly (1619.19) in patients with AKI (p<0.0001). Similarly, higher levels of D-dimer (426.35) and lower serum albumin (1.86) were associated with COVAKI (p<0.0001). The average ICU stay was six days for patients with AKI and 0.37 days for patients without AKI. Days on the ventilator were 3.3 days for patients with AKI and 0.11 days for non-AKI patients. Out of a total 12 deaths of COVID-19 patients over these two months, nine had AKI. This made the association statistically significant (p<0.0001). Conclusion The phenotype COVAKI was associated with higher inflammatory markers, prolonged hospital stay, days spent on a ventilator, and higher oxygen requirement translating into higher mortality compared to those without COVAKI. We found low serum albumin without a corresponding proteinuria or liver dysfunction. The development of COVAKI during the hospital stay was associated with the use of glucocorticoids, hydroxychloroquines (HCQs), and heparin.
20%至70%的新冠肺炎患者会发生急性肾损伤（AKI）。AKI是一种具有多种病因和结局的综合征诊断。这项横断面研究探讨了新冠肺炎住院患者中AKI的不同结局。
这是一项在马哈拉施特拉邦西部一家三级护理教学医院进行的为期两个月（2020年5月至6月）的横断面描述性研究。我们连续两个月收集了456例新冠肺炎住院患者的临床和实验室数据。我们排除了入院时已在接受透析的患者。研究主要包括在住院期间发生AKI的患者。
与AKI相关的新冠肺炎患者（COVAKI）的C反应蛋白（CRP）升高（78.87），但具有统计学意义（p<0.003）。AKI患者的铁蛋白显著升高（1619.19）（p<0.0001）。同样，较高水平的D-二聚体（426.35）和较低的血清白蛋白（1.86）与COVAKI相关（p<0.0001）。AKI患者的平均重症监护病房（ICU）住院时间为6天，无AKI患者为0.37天。使用呼吸机的天数，AKI患者为3.3天，非AKI患者为0.11天。在这两个月期间，456例新冠肺炎患者中共有12例死亡，其中9例有AKI。这使得两者之间的关联具有统计学意义（p<0.0001）。
与无COVAKI的患者相比，COVAKI表型与更高的炎症标志物、更长的住院时间、使用呼吸机的天数以及更高的氧气需求相关，这意味着更高的死亡率。我们发现血清白蛋白水平低，但没有相应的蛋白尿或肝功能障碍。住院期间COVAKI的发生与使用糖皮质激素、羟氯喹（HCQ）和肝素有关。
