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Article

Clinical Features and Outcomes of Acute Kidney Injury in Critically Ill COVID-19 Patients: A Retrospective Observational Study

by
Nabil Bouguezzi
1,2,†,
Imen Ben Saida
1,2,†,
Radhouane Toumi
1,2,†,
Khaoula Meddeb
1,2,
Emna Ennouri
1,2,
Amir Bedhiafi
1,2,
Dhouha Hamdi
1,2 and
Mohamed Boussarsar
1,2,*
1
Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia
2
Medical Intensive Care Unit, Research Laboratory “Heart Failure”, LR12SP09, Farhat Hached University Hospital, Sousse 4000, Tunisia
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Clin. Med. 2023, 12(15), 5127; https://doi.org/10.3390/jcm12155127
Submission received: 21 January 2023 / Revised: 8 March 2023 / Accepted: 9 March 2023 / Published: 4 August 2023
(This article belongs to the Section Intensive Care)
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Abstract

Background: An alarming number of COVID-19 patients, especially in severe cases, have developed acute kidney injury (AKI). Aim: The study aimed to assess the frequency, risk factors, and impact of AKI on mortality in critically ill COVID-19 patients. Methods: The study was a retrospective observational study conducted in the MICU. Univariate and multivariate analyses were performed to identify risk factors for AKI and clinical outcomes. Results: During the study period, 465 consecutive COVID-19 patients were admitted to the MICU. The patients’ characteristics were median age, 64 [54–71] years; median SAPSII, 31 [24–38]; and invasive mechanical ventilation (IMV), 244 (52.5%). The overall ICU mortality rate was 49%. Two hundred twenty-nine (49.2%) patients developed AKI. The factors independently associated with AKI were positive fluid balance (OR, 2.78; 95%CI [1.88–4.11]; p < 0.001), right heart failure (OR, 2.15; 95%CI [1.25–3.67]; p = 0.005), and IMV use (OR, 1.55; 95%CI [1.01–2.40]; p = 0.044). Among the AKI patients, multivariate analysis identified the following factors as independently associated with ICU mortality: age (OR, 1.05; 95%CI [1.02–1.09]; p = 0.012), IMV use (OR, 48.23; 95%CI [18.05–128.89]; p < 0.001), and septic shock (OR, 3.65; 95%CI [1.32–10.10]; p = 0.012). Conclusion: The present study revealed a high proportion of AKI among critically ill COVID-19 patients. This complication seems to be linked to a severe cardiopulmonary interaction and fluid balance management, thus accounting for a poor outcome.
Keywords: acute kidney injury; COVID-19; intensive care; outcomes; mortality acute kidney injury; COVID-19; intensive care; outcomes; mortality

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MDPI and ACS Style

Bouguezzi, N.; Ben Saida, I.; Toumi, R.; Meddeb, K.; Ennouri, E.; Bedhiafi, A.; Hamdi, D.; Boussarsar, M. Clinical Features and Outcomes of Acute Kidney Injury in Critically Ill COVID-19 Patients: A Retrospective Observational Study. J. Clin. Med. 2023, 12, 5127. https://doi.org/10.3390/jcm12155127

AMA Style

Bouguezzi N, Ben Saida I, Toumi R, Meddeb K, Ennouri E, Bedhiafi A, Hamdi D, Boussarsar M. Clinical Features and Outcomes of Acute Kidney Injury in Critically Ill COVID-19 Patients: A Retrospective Observational Study. Journal of Clinical Medicine. 2023; 12(15):5127. https://doi.org/10.3390/jcm12155127

Chicago/Turabian Style

Bouguezzi, Nabil, Imen Ben Saida, Radhouane Toumi, Khaoula Meddeb, Emna Ennouri, Amir Bedhiafi, Dhouha Hamdi, and Mohamed Boussarsar. 2023. "Clinical Features and Outcomes of Acute Kidney Injury in Critically Ill COVID-19 Patients: A Retrospective Observational Study" Journal of Clinical Medicine 12, no. 15: 5127. https://doi.org/10.3390/jcm12155127

APA Style

Bouguezzi, N., Ben Saida, I., Toumi, R., Meddeb, K., Ennouri, E., Bedhiafi, A., Hamdi, D., & Boussarsar, M. (2023). Clinical Features and Outcomes of Acute Kidney Injury in Critically Ill COVID-19 Patients: A Retrospective Observational Study. Journal of Clinical Medicine, 12(15), 5127. https://doi.org/10.3390/jcm12155127

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