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Abstract: TH-PO910

Characteristics and Outcomes of Community and Hospital Acquired AKI in Patients With COVID-19

Session Information

  • COVID-19: Long COVID
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Claure-Del Granado, Rolando, Hospital Obrero No 2 - CNS, Cochabamba, Bolivia, Plurinational State of
  • Oliva-Cadima, Leydi M., Hospital Obrero No 2 - CNS, Cochabamba, Bolivia, Plurinational State of
  • Macedo, Etienne, University of California San Diego, La Jolla, California, United States
  • Mehta, Ravindra L., University of California San Diego, La Jolla, California, United States
Background

Acute kidney injury (AKI) is common in coronavirus disease 2019 (COVID-19). It is unknown if hospital-acquired AKI (HA-AKI) and community-acquired AKI (CA-AKI) convey a distinct prognosis. The study aim was to evaluate the incidence and risk factors associated with both CA-AKI and HA-AKI.

Methods

Consecutive patients (>18 years) hospitalized with a positive antigen or RT-PCR result for COVID-19 who meet the criteria for AKI, have known CKD or with kidney transplant were included in this prospective cohort study. Patient information was recorded from the time of diagnosis and renal function was followed up at 48 hours, 7 days, 14 days, at discharge, and at 6 months.

Results

From July 1st to May 30th 2021, we included 100 hospitalized patients with AKI, 68% were male and mean age was 68±11. Seventy-two (72%) corresponded to CA-AKI, and 28% to HA-AKI. Compared to patients with HA-AKI, subjects with CA-AKI have higher baseline sCr (1.15±0.46 vs.1.06±0.26, p <0.001); had more diabetes (14[19.4%] vs. 1[3,6%], p=0.035); and presented to the emergency department with more severe disease. However the presence of ≥2 comorbidities were higher in HA-AKI (27.7% vs. 32,1%, p=0.014). Mortality rates were not different between CA-AKI and HA-AKI (14 [19%] vs. 5 [18%], p=0.856). Complete renal recover was more frequent in CA-AKI (16[22%] vs. 5[18%], p<0,001) with lower incidence of de novo CKD (13 [29%] vs.13 [65%], p=0.033) or CKD progression (8[18%] vs. 0[0%], p=0.033].

Conclusion

CA-AKI and HA-AKI portend an adverse prognosis in COVID-19 patients. Nevertheless, CA-AKI was associated with a higher rate of renal recovery and lower incidence of long term adverse outcomes like de novo CKD or CKD progression. HA-AKI is likely part of the multiorgan failure, has a more severe course than CA-AKI, and that kidney injury contributes to worse outcomes.