Acute kidney injury in patients with severe COVID-19 in Mexico
| Autor: | Mauricio González-Navarro, Christopher E. Ormsby, Santiago Ávila-Ríos, Claudia Alvarado-de la Barrera, Isabel León-Rodríguez, Amy B. Peralta-Prado, Yara Luna-Villalobos, Alejandro Velasco-Morales, Natalia Calderón-Dávila, Gustavo A. Casas-Aparicio |
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| Rok vydání: | 2021 |
| Předmět: |
Male
RNA viruses Viral Diseases Pulmonology Physiology Epidemiology Coronaviruses medicine.medical_treatment Kaplan-Meier Estimate 030204 cardiovascular system & hematology urologic and male genital diseases Body Mass Index Medical Conditions 0302 clinical medicine Furosemide Risk Factors Medicine and Health Sciences 030212 general & internal medicine Stage (cooking) Pathology and laboratory medicine Virus Testing Multidisciplinary Medical record Acute kidney injury Acute Kidney Injury Middle Aged Medical microbiology female genital diseases and pregnancy complications Infectious Diseases Physiological Parameters Viruses Cohort Medicine Female Anatomy SARS CoV 2 Pathogens Research Article medicine.drug medicine.medical_specialty SARS coronavirus Science Microbiology 03 medical and health sciences Diagnostic Medicine Internal medicine medicine Humans Obesity Mexico Inflammation Mechanical ventilation SARS-CoV-2 business.industry Body Weight Organisms Viral pathogens COVID-19 Biology and Life Sciences Covid 19 Kidneys Renal System Pneumonia medicine.disease Microbial pathogens ROC Curve Medical Risk Factors business Body mass index Biomarkers |
| Zdroj: | PLoS ONE PLoS ONE, Vol 16, Iss 2, p e0246595 (2021) |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0246595 |
| Popis: | Introduction Some patients with COVID-19 pneumonia present systemic disease involving multiple systems. There is limited information about the clinical characteristics and events leading to acute kidney injury (AKI). We described the factors associated with the development of AKI and explored the relation of AKI and mortality in Mexican population with severe COVID-19. Methods We retrospectively reviewed the medical records of individuals with severe pneumonia caused by SARS-CoV-2 hospitalized at the largest third-level reference institution for COVID-19 care in Mexico between March and April 2020. Demographic information, comorbidities, clinical and laboratory data, dates of invasive mechanical ventilation (IMV) and hospitalization, mechanical-ventilator settings and use of vasoactive drugs were recorded. Results Of 99 patients studied, 58 developed AKI (58.6%). The risk factors for AKI were older age (OR = 1.07, 95% CI = 1.01–1.13, p = 0.024); obesity (OR = 6.58, 95% CI = 1.8–24.05, p = 0.040); and the need for IMV (OR = 6.18, CI = 1.29–29.58, p = 0.023). The risk factors for mortality were obesity (OR = 5.57, 95% CI = 1.48–20.93, p = 0.011); requirement of vasoactive drugs on admission (OR = 5.35, 95% CI = 1.16–24.61, p = 0.031); and AKI (OR = 8.61, 95% CI = 2.24–33.1, p = 0.002). In-hospital mortality was significantly higher in patients with AKI stage 3 (79.3%) and AKI stage 2 (68.7%) compared with those with AKI stage 1 (25%; p = 0.004). Fifty-three patients underwent the furosemide stress test (FST) to predict progression to AKI stage 3. Of those, 12 progressed to AKI stage 3 (22%). The ROC curve for the FST had an AUC of 0.681 (p = 0.009); a sensitivity of 81.6% and a specificity of 54.5%. Conclusions AKI was common in our cohort of patients with severe pneumonia caused by SARS-CoV-2 infection. The risk factors for AKI were older age, obesity and the need for of IMV on admission. The risk factors for mortality were obesity, requirement of vasoactive drugs on admission and AKI. Mortality was more frequent in patients with AKI stages 2–3. The FST had an acceptable predictive capacity to identify patients progressing to AKI stage 3. |
| Databáze: | OpenAIRE |
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