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

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0
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article
Data de publicação
2023
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Scopus
Web of Science
PubMed
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PUBLIC LIBRARY SCIENCE
Autores
SAMAAN, Farid
FREITAS, Rafaela Andrade Penalva
VIANA, Renata
GAMBARO, Livia
CUNHA, Karlla
VIEIRA, Tales Dantas
FEITOSA, Valkercyo
CORREA, Eric Aragao
MACIEL, Alexandre Toledo
ARANHA, Sylvia
Citação
PLOS ONE, v.18, n.11, article ID e0293846, 16p, 2023
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Unidades Organizacionais
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IntroductionThis 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.MethodsA 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.ResultsWe 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.ConclusionsIn 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.
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https://observatorio.fm.usp.br/handle/OPI/57824
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - COVID-19
Artigos e Materiais de Revistas Científicas - LIM/12
Artigos e Materiais de Revistas Científicas - ODS/03
Artigos e Materiais de Revistas Científicas - ODS/10