Borrego-Moreno Juan Carlos, Cárdenas-de Luna María Julieta, Márquez-Castillo José Carlos, Reyes-Ruiz José Manuel, Osuna-Ramos Juan Fidel, León-Juárez Moisés, Del Ángel Rosa María, Rodríguez-Carlos Adrián, Rivas-Santiago Bruno, Farfan-Morales Carlos Noe, García-Herrera Ana Cristina, De Jesús-González Luis Adrián
Instituto Mexicano del Seguro Social, Hospital General de Zona # 1, Servicio de Epidemiologia, Zacatecas 98000, Mexico.
Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar # 1, Servicio de Medicina Familiar, Guadalupe, Zacatecas 98608, Mexico.
Infect Dis Rep. 2024 May 16;16(3):458-471. doi: 10.3390/idr16030034.
During the COVID-19 pandemic, a considerable proportion of patients developed a severe condition that included respiratory failure, shock, or multiple organ dysfunction. Acute Kidney Injury (AKI) has been recognized as a possible cause of severe COVID-19 development. Given this, this study investigates the occurrence and consequences of AKI in Mexican patients to contribute to better knowledge and management of this problem. : Using a retrospective observational cohort methodology, we investigated 313 cases from a cohort of 1019 patients diagnosed with COVID-19 at the IMSS Zacatecas General Hospital of Zone No. 1 in 2020. The prevalence of AKI was determined using the AKIN criteria based on serum creatinine levels and a detailed review of demographic characteristics, medical history, comorbidities, and clinical development. : The data showed a 25.30% prevalence of AKI among patients infected with severe COVID-19. Remarkably, these patients with AKI exhibited an advanced age (>65 years), arterial hypertension, a higher number of white blood cells during admission and the hospital stay, and elevated levels of C-reactive protein, serum creatinine, and blood urea nitrogen (BUN). Clinically, patients with AKI had signs of prostration, pneumonia, and the requirement for ventilatory assistance when compared to those without AKI. Finally, those diagnosed with AKI and COVID-19 had a 74% death rate. Relative risk analyses indicated that age (>65 years), arterial hypertension, high creatinine levels, endotracheal intubation, and pneumonia are associated with the development of AKI. On the other hand, among the protective factors against AKI, high hemoglobin levels and the consumption of statins during COVID-19 were found. : The findings of this study underscore the significance of promptly identifying and effectively managing AKI to potentially alleviate the negative consequences of this complication within the Mexican population during COVID-19.
在新冠疫情期间，相当一部分患者病情严重，包括呼吸衰竭、休克或多器官功能障碍。急性肾损伤（AKI）已被认为是重症新冠病情发展的一个可能原因。鉴于此，本研究调查了墨西哥患者中AKI的发生情况及后果，以促进对该问题的更好认识和管理。：采用回顾性观察队列研究方法，我们调查了2020年在第1区萨卡特卡斯综合医院IMSS确诊为新冠的1019名患者队列中的313例病例。根据血清肌酐水平采用AKIN标准确定AKI的患病率，并详细回顾人口统计学特征、病史、合并症和临床进展。：数据显示，重症新冠感染患者中AKI的患病率为25.30%。值得注意的是，这些AKI患者年龄较大（>65岁）、患有动脉高血压，入院和住院期间白细胞数量较多，C反应蛋白、血清肌酐和血尿素氮（BUN）水平升高。临床上，与无AKI的患者相比，AKI患者有虚脱、肺炎迹象且需要通气辅助。最后，被诊断为AKI和新冠的患者死亡率为74%。相对风险分析表明，年龄（>65岁）、动脉高血压、高肌酐水平、气管插管和肺炎与AKI的发生有关。另一方面，在预防AKI的保护因素中，发现了高血红蛋白水平和新冠期间服用他汀类药物。：本研究结果强调了及时识别和有效管理AKI的重要性，以在新冠疫情期间可能减轻墨西哥人群中这种并发症的负面影响。
