Acute Kidney Injury among Hospital-Admitted COVID-19 Patients: A Study from Jordan

OBJECTIVE: During the COVID-19 pandemic, many patients have been admitted to hospitals with severe respiratory disease and suffered complications. Acute kidney injury (AKI) is among the more dangerous complications contributing to morbidity and mortality among patients. METHODS: This retrospective study focused on all hospital-admitted COVID-19 patients between September and December 2020. A total of 1,044 patients were enrolled. Patient demographics, medical records, and laboratory data were gathered. Patients were split into two groups: AKI and non-AKI. Comparisons comprised demographics, labs, ICU transfer, need for ventilation and oxygen therapy, medications, hospital stay, and deaths. RESULTS: AKI incidence in the cohort was 25.3%, and a majority were stage 1 (53.3%). Among these, hemodialysis was started in 1.8%. Higher age (P<0.001), diabetes mellitus (P=0.001), hypertension (P=0.001), ACEI/ARB use (P=0.008), erythrocyte-sedimentation rate (P=0.002), CRP (P<0.0001), and ferritin (P=0.01) were predictors of AKI. Among all admitted COVID-19 patients, 30.2% died in hospital. Among those with AKI, 75.9% died in comparison to 24.1% of non-AKI patients (P<0.001). Among COVID-19 patients admitted to the ICU, 80.5% died: 70.5% were from the AKI group and 29.5% from the non-AKI group (P<0.001). CONCLUSION: High mortality and morbidity is associated with COVID-19 infection, and AKI is contributing significantly to the outcomes of hospitalized patients with the infection. Early recognition of and treatment for AKI will decrease mortality and hospitalization in patients with COVID-19.