MULTIORGAN FAILURES IN COVID-19 PATIENTS AND THEIR ASSOCIATION WITH ADVERSE OUTCOMES

Objectives: Organ and kidney failures often occur in patients with severe COVID-19. This study set out to assess organ and kidney failures in COVID-19 patients and their correlation with poor outcomes. Methods: This retrospective analytical study involved 311 unvaccinated COVID-19 patients admitted at hospital between April and August 2021. Patients’ clinical and laboratory information were statistically analyzed. Severity of organ dysfunction was examined using the sequential organ failure assessment (SOFA) score, and kidney dysfunction was assessed using renal parameters and Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results: Of the COVID-19 patients, 20.6% (n=64) had kidney dysfunction with common signs of albuminuria [68 (21.8%)] and hematuria [56 (18%)]. Older age, comorbidities, need of mechanical ventilation, chronic kidney disorders, higher SOFA scores, hypoxemia, lymphopenia, albuminuria, and hematuria all associated with COVID-19 severity (P<0.05). The mortality rate was 10%, noting a higher mortality risk in patients with severe infection. The mentioned factors, especially older age, chronic liver/biliary disease, higher SOFA, and lower PaO₂/FiO₂ ratio were independently related to high risk of mortality (P<0.05). However, the zero mortality rate in non-severe group indirectly highlights the dominant role of infection severity for patients’ outcomes and the link between the survival and organ failures. Conclusions: Organ and kidney failures were key indicators of severe COVID-19 and risk of death. However, the severity of COVID-19 remained the paramount factor influencing both survival status and its association with organ and kidney dysfunction. Monitoring these factors can help the sorting and management of patients according to risk.