PLoS ONE (Jan 2021)

Mortality and evolution between community and hospital-acquired COVID-AKI

  • Jonathan S. Chávez-Íñiguez,
  • José H. Cano-Cervantes,
  • Pablo Maggiani-Aguilera,
  • Natashia Lavelle-Góngora,
  • Josué Marcial-Meza,
  • Estefanía P. Camacho-Murillo,
  • Cynthia Moreno-González,
  • Jarumi A. Tanaka-Gutiérrez,
  • Ana P. Villa Zaragoza,
  • Karla E. Rincón-Souza,
  • Sandra Muñoz-López,
  • Olivia Montoya-Montoya,
  • Guillermo Navarro-Blackaller,
  • Aczel Sánchez-Cedillo,
  • Luis E. Morales-Buenrostro,
  • Guillermo García-García

Journal volume & issue
Vol. 16, no. 11

Abstract

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Background Acute kidney injury (AKI) is associated with poor outcomes in COVID patients. Differences between hospital-acquired (HA-AKI) and community-acquired AKI (CA-AKI) are not well established. Methods Prospective, observational cohort study. We included 877 patients hospitalized with COVID diagnosis at two third-level hospitals in Mexico. Primary outcome was all-cause mortality at 28 days compared between COVID patients with CA-AKI and HA-AKI. Secondary outcomes included the need for KRT, and risk factors associated with the development of CA-AKI and HA-AKI. Results A total of 377 patients (33.7%) developed AKI. CA-AKI occurred in 202 patients (59.9%) and HA-AKI occurred in 135 (40.1%). Patients with CA-AKI had more significant comorbidities, including diabetes (52.4% vs 38.5%), hypertension (58.4% vs 39.2%), CKD (30.1% vs 14.8%), and COPD (5.9% vs 1.4%), than those with HA-AKI. Patients’ survival without AKI was 87.1%, with CA-AKI it was 75.4%, and with HA-AKI it was 69.6%, log-rank test p 60 years (OR 1.12, 95% CI 1.06–1.18, p Conclusions We found that COVID patients who are complicated by CA-AKI have more comorbidities and worse biochemical parameters at the time of hospitalization than HA-AKI patients, but despite these differences, their probability of dying is similar.