The following is a summary of “Dynamics and outcomes of AKI progression during the COVID-19 pandemic,” published in the March 2024 issue of Nephrology by Ratnayake et al.
Patients associated with COVID-19 along with Acute Kidney Injury have a poor prognosis.
Researchers conducted a retrospective study to determine the impact COVID-19 has on the progression and clinical outcomes of patients with AKI.
They studied patients with AKI admitted between (13/3/20 – 13/5/20). Logistic regression and multi-state models revealed insights into AKI progression dynamics associated with PCR-confirmed COVID-19 acquisition and death. Meta-analysis of case fatality ratios was also conducted.
The results showed the overall case-fatality ratio was 0.33 [95% CI (0.20-0.36)], higher in COVID-positive patients 0.52 [95% CI (0.46-0.58)] than in their negative counterparts 0.15 [95% CI 90.12-0.20)]. In AKI Stage-3 patients, that was 0.71 [95% CI (0.64-0.79)] among COVID+ patients, with 45% dead within 14 days and 0.35 [95% CI (0.25-0.44)] in the COVID- group and 28% died within 14 days. Among patients with AKI stage-1, the probability of progression to AKI-stage-3 was 0.22 [95% CI (0.17-0.27)] among COVID+ patients, and 0.06 [95% CI (0.03-0.09)] among COVID- patients. By the 7th day, the probability of discharge was 0.71 [95% CI (0.66-0.75)] in COVID- patients, whereas in COVID+ patients, it was 0.27 [95% CI (0.21-0.32)]. By day 10, in AKI Stage-3 COVID+ patients, the probability of discharge was 0.38 [95% CI (0.29 -0.47)], which by day 14 became 0.35 [95% CI (0.25-0.44)].
Investigators concluded that patients with COVID demonstrated a higher case fatality ratio in AKI Stage-3 patients, along with either rapid progression in severity or prolonged hospital care.