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Acute kidney injury is a frequently complication in patients with severe COVID-19. It worsens the vital prognosis of the disease. The prevalence of Acute kidney injury in COVID-19 remains poorly evaluated in sub-Saharan Africa. It was in this context that we carried out this study, the objectives of which were to assess the prevalence of Acute kidney injury in COVID-19 and to identify associated factors.
This was a retrospective, descriptive and analytical study over an 18-month period from May 1, 2020 to October 30, 2021 at Dalal Jamm Hospital. We had included all patients admitted to the ICU for management of COVID-19. Acute kidney injury was defined according to KDIGO 2012.
During the study period, 170 cases were collected. The mean age was 59.38 ± 14.81 years. There were 101 men (59.4%) and 69 women (40.6%), giving a sex ratio of 1.46. Hypertension, diabetes mellitus and obesity were the most frequently found comorbidities, respectively in 37.65%, 31.18% and 5.3% of cases. Anuria was present in 16 (9.4%) patients. Acute kidney injury was present in 50 (29.4%) patients. Acute tubular necrosis was found in 44%. Mean serum creatinine was 16.89 ± 24.09 mg/L, with extremes of 2.3 and 164.8 mg/L. Hyperkalemia was present in 24 patients. RT-PCR was performed in 135 patients and was positive in 96.3% of cases. Chest CT scans showed lesions suggestive of COVID-19 in 113 patients. Dexamethasone was used in 92.3% of cases. Hemodialysis was performed in 10% of cases, and the indications were: hyperkalemia (100%), uremic encephalopathy (40%) and pulmonary edema (20%). Death occurred in 37% of cases. Recovery of renal function during hospitalization was noted in 16% of patients. On multivariate analysis, factors associated with Acute kidney injury were obesity (p=0.032), qSOFA ≥ 2 (p=0.017), multivisceral failure (p= 0.006) and prolonged hospital stay (p=0.015).
Acute kidney injury is common in COVID-19. Its presence is correlated with disease severity and the presence of comorbidities.