Abstract
Introduction: Infection with SARS-CoV-2 might lead to severe acute kidney injury (AKI) with high morbidity and mortality. Various incidence rates of AKI have been reported among hospitalized patients with COVID-19. Our study aimed to investigate the risk factors associated with AKI in hospitalized COVID-19 patients and the relevant changes in their blood biomarkers compared to COVID-19 patients without AKI.
Methods: In this retrospective cross-sectional study, 262 COVID-19-confirmed hospitalized patients were enrolled in the Department of Internal Medicine at Bohlool teaching hospital, Iran, from September 2019 to January 2020. Then, the information related to demographics, medical history, comorbid conditions, and clinical and laboratory findings was documented. Patients were categorized into two groups: Patients without AKI and patients with AKI.
Results: We detected 130 (49.6%) patients with AKI among the total number of 262 patients admitted with COVID-19. A total of 68 (25.9%) patients had severe disease, and fever (47.1%) was the most common presenting symptom. Older age, comorbid cardiovascular diseases (CVD), and severe COVID-19 were significantly associated with higher risk of AKI. Abnormal levels of white blood cells (WBC), neutrophil count, hemoglobin (Hb), prothrombin time (PT), international normalized ratio (INR), D-dimer, C-reactive protein (CRP), alkaline phosphatase (ALP), direct bilirubin, blood urea nitrogen (BUN), creatinine, potassium (K), ferritin (in female patients), albumin (Alb), pH, and oxygen saturation (SPO2 ) was significantly associated with a higher risk of developing AKI in COVID-19 patients.
Conclusion: AKI was a common condition among COVID-19 patients in our sample. Our study confirms the effect of COVID-19 on the developing of AKI. The association between blood biomarkers, including hematologic and inflammatory markers indicate their potential role in the impairment of kidney function.