Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19


Wainstein, Marina, Spyrison, Nicholas, Dai, Danyang, Ghadimi, Moji, Chávez-Iñiguez, Jonathan S, Rizo-Topete, Lilia, Citarella, Barbara Wanjiru, Merson, Laura, Pole, Jason D, Claure-Del Granado, Rolando et al (show 1435 more authors) (2023) Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19. Kidney International Reports, 8 (8). pp. 1514-1530.

Access the full-text of this item by clicking on the Open Access link.

Abstract

Introduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population. Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay. Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity. Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes.

Item Type: Article
Uncontrolled Keywords: ISARIC Characterization Group
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 31 Aug 2023 07:35
Last Modified: 17 Nov 2023 10:32
DOI: 10.1016/j.ekir.2023.05.015
Open Access URL: https://doi.org/10.1016/j.ekir.2023.05.015
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3172448
Dimensions
Altmetric
CORE (COnnecting REpositories)