PLoS ONE (Jan 2023)

Critically ill patients with COVID-19-associated acute kidney injury treated with kidney replacement therapy: Comparison between the first and second pandemic waves in São Paulo, Brazil.

  • Farid Samaan,
  • Rafaela Andrade Penalva Freitas,
  • Renata Viana,
  • Lívia Gâmbaro,
  • Karlla Cunha,
  • Tales Dantas Vieira,
  • Valkercyo Feitosa,
  • Eric Aragão Correa,
  • Alexandre Toledo Maciel,
  • Sylvia Aranha,
  • Eduardo Atsushi Osawa,
  • Roberta Pillar,
  • Elias Marcos da Silva Flato,
  • Renata Cristina da Silva,
  • Elisa Carneiro,
  • Fabrizzio Batista Guimarães de Lima Souza,
  • Paula Regina Gan Rossi,
  • Munira Bittencourt Abud,
  • Henrique Pinheiro Konigsfeld,
  • Riberto Garcia da Silva,
  • Ricardo Barbosa Cintra de Souza,
  • Saurus Mayer Coutinho,
  • Miguel Ângelo Goes,
  • Bárbara Antunes Bruno da Silva,
  • Dirce Maria Trevisan Zanetta,
  • Emmanuel Almeida Burdmann

DOI
https://doi.org/10.1371/journal.pone.0293846
Journal volume & issue
Vol. 18, no. 11
p. e0293846

Abstract

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IntroductionThis study aimed to compare the characteristics and outcomes of critically ill patients with COVID-19-associated acute kidney injury (AKI) who were treated with kidney replacement therapy (KRT) in the first and second waves of the pandemic in the megalopolis of Sao Paulo, Brazil.MethodsA multicenter retrospective study was conducted in 10 intensive care units (ICUs). Patients aged ≥18 years, and treated with KRT due to COVID-19-associated AKI were included. We compared demographic, laboratory and clinical data, KRT parameters and patient outcomes in the first and second COVID-19 waves.ResultsWe assessed 656 patients (327 in the first wave and 329 in the second one). Second-wave patients were admitted later (7.1±5.0 vs. 5.6±3.9 days after the onset of symptoms, pConclusionsIn the Sao Paulo megalopolis, the lethality of critically ill patients with COVID-19-associated AKI treated with KRT was higher in the second wave of the pandemic, despite these patients being younger and having fewer comorbidities. Potential factors related to this poor outcome were difficulties in health care access, lack of intra-hospital resources, delay vaccination and virus variants.