Kidney Week

Abstract: PUB007

AKI in Severe COVID-19: Incidence, Severity, and Mortality in a Single-Center Cohort from Karbala, Iraq

Session Information

• Publication Only

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Al-Saegh, Riyadh Muhi A., University of Kerbala Faculty of Medicine, Karbala, Karbala Governorate, Iraq

Riyadh Muhi A. Al-Saegh, MD, FASN

• Kadhim, Mustafa Jawad Kadhim, Kerbala Health Directorate, Karbala, Karbala Governorate, Iraq

Mustafa Jawad Kadhim Kadhim, MD

• Al Kurati, Mohamed Makki, University of Kerbala Faculty of Medicine, Karbala, Karbala Governorate, Iraq

Mohamed Makki Al Kurati, MbChB

• Al-Saegh, Ameer Riyadh, Al Saegh Center for Nephrology and Kidney Transplantation, Karbala, Karbala Governorate, Iraq

Ameer Riyadh Al-Saegh, MD, MBChB

• Al Fatlawi, Al Hasan Hammood Hasan, Kerbala Health Directorate, Karbala, Karbala Governorate, Iraq

Al Hasan Hammood Hasan Al Fatlawi, MD

• Altai, Mohamed Munir, Kerbala Health Directorate, Karbala, Karbala Governorate, Iraq

Mohamed Munir Altai, MD

Group or Team Name

• Al Saegh research group

Background

SARS-CoV-2 causes multisystem disease with AKI associated with increased mortality. Reported AKI incidence in hospitalized COVID-19 is 4%–36%. Data from Iraq are limited. We assessed AKI incidence, KDIGO stage, and mortality in severe COVID-19 in Karbala.

Methods

Single-center cohort study in Karbala, Iraq. Of 280 adults with COVID-19, 200 with severe disease were included. AKI was defined by KDIGO using admission creatinine. Variables included comorbidities, labs, CT, and therapy. Outcomes were in-hospital mortality and AKI incidence/stage; Chi-square/Fisher’s test, RR and OR were used; p<0.05 was significant.

Results

Among 200 patients, AKI occurred in 13% of severe COVID-19 cases and was predominantly KDIGO stage 2–3. Overall mortality was 20.0% and was markedly higher in patients with AKI compared with those without (76.9% vs 11.5%). AKI was strongly associated with in-hospital death (RR 6.69; OR 25.7; p<0.001). It correlated with older age, comorbidities (CKD, diabetes, hypertension), and elevated inflammatory markers, but not CRP. Findings support a thrombo-inflammatory mechanism and confirm AKI as a major prognostic factor in severe COVID-19.

Conclusion

AKI occurred in 13% of severe COVID-19 cases, mainly KDIGO 2–3, and was strongly associated with increased mortality. Early detection and supportive care may improve outcomes.

Acknowledgment

We thank patients and healthcare workers involved in COVID-19 care.

Baseline characteristics, KDIGO-defined AKI severity, and in-hospital mortality (n=200)

Data are n (%) or mean (range). AKI defined/staged by KDIGO. Mortality compared between AKI and non-AKI. Effect estimates reported as RR (95% CI) and OR; p<0.05 significant.

Funding

• Government Support – Non-U.S.