Dataset Information

Critically ill patients with COVID-19-associated acute kidney injury treated with kidney replacement therapy: Comparison between the first and second pandemic waves in Sao Paulo, Brazil.

ABSTRACT:

Introduction

This study aimed to compare the characteristics and outcomes of critically ill patients with COVID-19-associated acute kidney injury (AKI) who were treated with kidney replacement therapy (KRT) in the first and second waves of the pandemic in the megalopolis of Sao Paulo, Brazil.

Methods

A multicenter retrospective study was conducted in 10 intensive care units (ICUs). Patients aged ≥18 years, and treated with KRT due to COVID-19-associated AKI were included. We compared demographic, laboratory and clinical data, KRT parameters and patient outcomes in the first and second COVID-19 waves.

Results

We assessed 656 patients (327 in the first wave and 329 in the second one). Second-wave patients were admitted later (7.1±5.0 vs. 5.6±3.9 days after the onset of symptoms, p<0.001), were younger (61.4±13.7 vs. 63.8±13.6 years, p = 0.023), had a lower frequency of diabetes (37.1% vs. 47.1%, p = 0.009) and obesity (29.5% vs. 40.0%, p = 0.007), had a greater need for vasopressors (93.3% vs. 84.6%, p<0.001) and mechanical ventilation (95.7% vs. 87.8%, p<0.001), and had higher lethality (84.8% vs. 72.7%, p<0.001) than first-wave patients. KRT quality markers were independently associated with a reduction in the OR for death in both pandemic waves.

Conclusions

In the Sao Paulo megalopolis, the lethality of critically ill patients with COVID-19-associated AKI treated with KRT was higher in the second wave of the pandemic, despite these patients being younger and having fewer comorbidities. Potential factors related to this poor outcome were difficulties in health care access, lack of intra-hospital resources, delay vaccination and virus variants.

SUBMITTER: Samaan F

PROVIDER: S-EPMC10624321 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Critically ill patients with COVID-19-associated acute kidney injury treated with kidney replacement therapy: Comparison between the first and second pandemic waves in São Paulo, Brazil.

Samaan Farid F Freitas Rafaela Andrade Penalva RAP Viana Renata R Gâmbaro Lívia L Cunha Karlla K Vieira Tales Dantas TD Feitosa Valkercyo V Correa Eric Aragão EA Maciel Alexandre Toledo AT Aranha Sylvia S Osawa Eduardo Atsushi EA Pillar Roberta R Flato Elias Marcos da Silva EMDS da Silva Renata Cristina RC Carneiro Elisa E Souza Fabrizzio Batista Guimarães de Lima FBGL Rossi Paula Regina Gan PRG Abud Munira Bittencourt MB Konigsfeld Henrique Pinheiro HP da Silva Riberto Garcia RG de Souza Ricardo Barbosa Cintra RBC Coutinho Saurus Mayer SM Goes Miguel Ângelo MÂ da Silva Bárbara Antunes Bruno BAB Zanetta Dirce Maria Trevisan DMT Burdmann Emmanuel Almeida EA

PloS one 20231103 11

<h4>Introduction</h4>This study aimed to compare the characteristics and outcomes of critically ill patients with COVID-19-associated acute kidney injury (AKI) who were treated with kidney replacement therapy (KRT) in the first and second waves of the pandemic in the megalopolis of Sao Paulo, Brazil.<h4>Methods</h4>A multicenter retrospective study was conducted in 10 intensive care units (ICUs). Patients aged ≥18 years, and treated with KRT due to COVID-19-associated AKI were included. We compa ...[more]

PMID: 37922282

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