Clinical Characteristics and Risk Factors Associated with Acute Kidney Injury among Hospitalized Primary COVID-19 Infected Patients

Background: Coronavirus disease 19 (COVID-19) mainly affects to respiratory system from mild to severe symptoms. Additionally, acute kidney injury (AKI) is an important complication causing substantially high morbidity and mortality. During the pandemic of COVID-19, Public health care in Thailand experienced many cases and complications. Objectives: This study demonstrated an incidence, clinical characteristic, independent risk factors of AKI and mortality in hospitalized COVID-19 patients with AKI and non-AKI patients. Methods: A retrospective, observational study was performed in Lesdsin Hospital from August 2021 to August 2022. A total of 576 hospitalized patients with diagnosis of COVID-19 infection were analyzed. AKI was diagnosed based on the extended Kidney Disease Global Outcomes (eKDIGO) criteria. Clinical characteristics were compared between COVID-19 patients with AKI and non-AKI patients. Independent risk factors were reported by adjusted odd ratios (aORs). Results: One hundred and forty-five patients developed AKI. The AKI group had higher proportion of male, older patients, and higher rate of pneumonia. Independent risk factors were: male gender (aOR, 1.84; 95% CI: 1.15-2.95), age ≥60 years (aOR, 2.03; 95% CI: 1.17-3.52), CKD (aOR, 5.45; 95% CI: 2.02-14.69), CAD (aOR, 3.25; 95% CI: 1.06-9.19), pneumonia (aOR, 4.03; 95% CI: 1.54-10.54), serum potassium ≥4.5 mEq/L (aOR, 2.30; 95% CI: 1.05-5.02), and serum bicarbonate/L (aOR, 2.37; 95% CI: 1.32-4.27). Lower proportion of AKI was shown in patients with history of COVID-19 vaccination (aOR, 0.45; 95% CI: 0.25-0.81). Conclusions: Independent risk factors had predictive value for AKI. Administration of COVID-19 vaccine had a potential role for AKI protection in patients with COVID-19.