Incidence of acute kidney injury (AKI) and outcomes in COVID-19 patients with and without antiviral medications: A retrospective study.

Autor: Mousavi Movahed SM; Baharloo Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran., Akhavizadegan H; Urology Department, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran., Dolatkhani F; Nephrology Department, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran., Akbarpour S; Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran., Nejadghaderi SA; School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.; Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran., Najafi M; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran., Pezeshki PS; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran., Khalili Noushabadi A; Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran., Ghasemi H; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Oct 11; Vol. 18 (10), pp. e0292746. Date of Electronic Publication: 2023 Oct 11 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0292746
Abstrakt: Background: Acute kidney injury is a complication of COVID-19 and is associated with severity. Despite no specific antiviral treatment strategy, lopinavir/ritonavir and remdesivir have been used. Data on the association between AKI and receiving antiviral agents with outcomes in hospitalized patients with COVID-19 is scarce. We aimed to determine the incidence of AKI and its outcomes in COVID-19 patients with and without antiviral medications.
Methods: We conducted a retrospective study on hospitalized adult patients with SARS-CoV-2 infection in a tertiary center. The primary endpoint was determining mortality, intensive care unit (ICU) admission, and length of hospitalization affected by AKI development using antiviral agents. The logistic regression method was used to explore the predictive effects of AKI and antiviral therapy on composite outcomes (i.e., mortality, ICU admission, and prolonged hospitalization) in four defined groups by AKI development/not and utilizing antivirals/not. We used IBM SPSS version 24.0 software for statistical analysis.
Results: Out of 833 COVID-19 patients who were included, 75 patients were treated with antiviral agents and developed AKI. There was a significant difference in the occurrence of AKI and using antiviral medications (p = 0.001). Also, the group using antiviral agents and the development of AKI had the highest rate of preexisting hypertension (p = 0.002). Of note, the group of patients who used antiviral agents and also developed AKI had the most remarkable association with our composite outcome (p<0.0001), especially ICU admission (OR = 15.22; 95% CI: 8.06-27.32).
Conclusions: The presence of AKI among COVID-19 patients treated with antiviral agents is linked to increased severity and mortality. Therefore, it is imperative to explore preventive measures for AKI development in patients receiving antiviral therapy. Larger-scale randomized controlled trials may be warranted to provide a more comprehensive understanding of these associations.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Mousavi Movahed et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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