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

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doi:10.1016/J.EKIR.2023.05.015

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 na-tions where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes.

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[10.1016/J.EKIR.2023.05.015]

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;Chavez-Iniguez, Jonathan S.;Rizo-Topete, Lilia;Citarella, Barbara Wanjiru;Merson, Laura;Pole, Jason D.;Claure-Del Granado, Rolando;Johnson, David W.;Shrapnel S.;Heryl Ann Abdukahil;Nurul Najmee Abdulkadir;Ryuzo Abe;Laurent Abel;Amal Abrous;Lara Absil;Andrew Acker;Shingo Adachi;Diana Adrião;Saleh Al Ageel;Shakeel Ahmed;Kate Ainscough;Eka Airlangga;Tharwat Aisa;Ali Ait Hssain;Younes Ait Tamlihat;Takako Akimoto;Ernita Akmal;Chika Akwani;Eman Al Qasim;Razi Alalqam;Angela Alberti;Tala Al-Dabbous;Senthilkumar Alegesan;Marta Alessi;Beatrice Alex;Kévin Alexandre;Abdulrahman Al-Fares;Huda Alfoudri;Imran Ali;Kazali Enagnon Alidjnou;Jeffrey Aliudin;Qabas Alkhafajee;Clotilde Allavena;Nathalie Allou;João Alves;Rita Alves;João Melo Alves;Joana Alves Cabrita;Maria Amaral;Nur Amira;Phoebe Ampaw;Roberto Andini;Claire Andréjak;Andrea Angheben;François Angoulvant;Séverine Ansart;Sivanesen Anthonidass;Massimo Antonelli;Carlos Alexandre Antunes de Brito;Ardiyan Apriyana;Yaseen Arabi;Irene Aragao;Francisco Arancibia;Carolline Araujo;Antonio Arcadipane;Patrick Archambault;Lukas Arenz;Jean-Benoît Arlet;Christel Arnold-Day;Lovkesh Arora;Rakesh Arora;Elise Artaud-Macari;Diptesh Aryal;Angel Asensio;Muhammad Ashraf;Jean Baptiste Assie;Amirul Asyraf;Minahel Atif;Anika Atique;Johann Auchabie;Hugues Aumaitre;Adrien Auvet;Laurène Azemar;Cecile Azoulay;Benjamin Bach;Delphine Bachelet;Claudine Badr;J Kenneth Baillie;J Kevin Baird;Erica Bak;Agamemnon Bakakos;Nazreen Abu Bakar;Andriy Bal;Mohanaprasanth Balakrishnan;Valeria Balan;Firouzé Bani-Sadr;Renata Barbalho;Nicholas Yuri Barbosa;Wendy S Barclay;Saef Umar Barnett;Michaela Barnikel;Audrey Barrelet;Cleide Barrigoto;Marie Bartoli;Joaquín Baruch;Romain Basmaci;Muhammad Fadhli Hassin Basri;Denise Battaglini;Jules Bauer;Diego Fernando Bautista Rincon;Abigail Beane;Alexandra Bedossa;Ker Hong Bee;Husna Begum;Sylvie Behilill;Albertus Beishuizen;Aleksandr Beljantsev;David Bellemare;Anna Beltrame;Beatriz Amorim Beltrão;Marine Beluze;Nicolas Benech;Lionel Eric Benjiman;Dehbia Benkerrou;Suzanne Bennett;Binny Benny;Luís Bento;Jan-Erik Berdal;Delphine Bergeaud;Hazel Bergin;José Luis Bernal Sobrino;Giulia Bertoli;Lorenzo Bertolino;Simon Bessis;Sybille Bevilcaqua;Karine Bezulier;Amar Bhatt;Krishna Bhavsar;Claudia Bianco;Farah Nadiah Bidin;Moirangthem Bikram Singh;Felwa Bin Humaid;Mohd Nazlin Bin Kamarudin;Zeno Bisoffi;François Bissuel;Patrick Biston;Laurent Bitker;Jonathan Bitton;Pablo Blanco-Schweizer;Catherine Blier;Frank Bloos;Mathieu Blot;Lucille Blumberg;Filomena Boccia;Laetitia Bodenes;Debby Bogaert;Anne-Hélène Boivin;Isabela Bolaños;Pierre-Adrien Bolze;François Bompart;Diogo Borges;Raphaël Borie;Elisabeth Botelho-Nevers;Lila Bouadma;Olivier Bouchaud;Sabelline Bouchez;Dounia Bouhmani;Damien Bouhour;Kévin Bouiller;Laurence Bouillet;Camile Bouisse;Anne-Sophie Boureau;John Bourke;Maude Bouscambert;Aurore Bousquet;Jason Bouziotis;Bianca Boxma;Marielle Boyer-Besseyre;Maria Boylan;Fernando Augusto Bozza;Axelle Braconnier;Cynthia Braga;Filipa Brás Monteiro;Luca Brazzi;Patrick Breen;Dorothy Breen;David Brewster;Kathy Brickell;Shaunagh Browne;Marjolein Brusse-Keizer;Petra Bryda;Nina Buchtele;Polina Bugaeva;Marielle Buisson;Erlina Burhan;Aidan Burrell;Ingrid G Bustos;Denis Butnaru;André Cabie;Susana Cabral;Eder Caceres;Cyril Cadoz;Rui Caetano Garcês;Kate Calligy;Jose Andres Calvache;João Camões;Valentine Campana;Paul Campbell;Josie Campisi;Mireia Cantero;Pauline Caraux-Paz;Chiara Simona Cardellino;Sofia Cardoso;Filipe Cardoso;Filipa Cardoso;Nelson Cardoso;Simone Carelli;Nicolas Carlier;Thierry Carmoi;Gayle Carney;Inês Carqueja;Marie-Christine Carret;François Martin Carrier;Ida Carroll;Gail Carson;Maire-Laure Casanova;Mariana Cascão;Siobhan Casey;José Casimiro;Bailey Cassandra;Nidyanara Castanheira;Guylaine Castor-Alexandre;Ivo Castro;Ana Catarino;François-Xavier Catherine;Paolo Cattaneo;Roberta Cavalin;Alexandros Cavayas;Minerva Cervantes-Gonzalez;Anissa Chair;Catherine Chakveatze;Adrienne Chan;Meera Chand;Christelle Chantalat Auger;Jean-Marc Chapplain;Charlotte Charpentier;Julie Chas;Jonathan Samuel Chávez Iñiguez;Anjellica Chen;Yih-Sharng Chen;Léo Chenard;Matthew Pellan Cheng;Antoine Cheret;Thibault Chiarabini;Julian Chica;Suresh Kumar Chidambaram;Leong Chin Tho;Catherine Chirouze;Davide Chiumello;Sung-Min Cho;Bernard Cholley;Marie-Charlotte Chopin;Ting Soo Chow;Yock Ping Chow;Hiu Jian Chua;Jonathan Chua;Jose Pedro Cidade;Barbara Wanjiru Citarella;Anna Ciullo;Jennifer Clarke;Rolando Claure-Del Granado;Sara Clohisey;Perren J Cobb;Cassidy Codan;Caitriona Cody;Alexandra Coelho;Megan Coles;Jennifer Coles;Gwenhaël Colin;Michael Collins;S.M. Colombo;Pamela Combs;Jennifer Connolly;Marie Connor;Anne Conrad;Elaine Conway;Graham S Cooke;Mary Copland;Hugues Cordel;Amanda Corley;Sabine Cornelis;Alexander Daniel Cornet;Arianne Joy Corpuz;Andrea Cortegiani;Grégory Corvaisier;Camille Couffignal;Sandrine Couffin-Cadiergues;Roxane Courtois;Stéphanie Cousse;Sabine Croonen;Gloria Crowl;Jonathan Crump;Claudina Cruz;Juan Luis Cruz Bermúdez;Jaime Cruz Rojo;Marc Csete;Ailbhe Cullen;Gerard Curley;Elodie Curlier;Colleen Curran;Paula Custodio;Ana da Silva Filipe;Charlene Da Silveira;Al-Awwab Dabaliz;Danyang Dai;Andrew Dagens;Darren Dahly;Heidi Dalton;Jo Dalton;Seamus Daly;Juliana Damas;Nick Daneman;Corinne Daniel;Emmanuelle A Dankwa;Jorge Dantas;Gillian de Loughry;Etienne De Montmollin;Rafael Freitas de Oliveira França;Rosanna De Rosa;Thushan de Silva;Peter de Vries;David Dean;Alexa Debard;Bianca DeBenedictis;Marie-Pierre Debray;Nathalie DeCastro;William Dechert;Lauren Deconninck;Romain Decours;Eve Defous;Isabelle Delacroix;Eric Delaveuve;Karen Delavigne;Andrea Dell'Amore;Christelle Delmas;Pierre Delobel;Corine Delsing;Elisa Demonchy;Emmanuelle Denis;Dominique Deplanque;Pieter Depuydt;Mehul Desai;Diane Descamps;Mathilde Desvallées;Santi Dewayanti;Pathik Dhanger;Alpha Diallo;Sylvain Diamantis;Fernanda Dias Da Silva;Juan Jose Diaz;Rodrigo Diaz;Kévin Didier;Jean-Luc Diehl;Wim Dieperink;Jérôme Dimet;Vincent Dinot;Fara Diop;Alphonsine Diouf;Yael Dishon;Félix Djossou;Annemarie B Docherty;Helen Doherty;Maria Donnelly;Christl A Donnelly;Sean Donohue;Yoann Donohue;Chloe Donohue;Peter Doran;Céline Dorival;Eric D'Ortenzio;James Joshua Douglas;Nathalie Dournon;Triona Downer;Joanne Downey;Mark Downing;Tom Drake;Aoife Driscoll;Murray Dryden;Claudio Duarte Fonseca;Vincent Dubee;François Dubos;Alexandre Ducancelle;Toni Duculan;Susanne Dudman;Abhijit Duggal;Paul Dunand;Jake Dunning;Mathilde Duplaix;Emanuele Durante-Mangoni;Lucian Durham 3rd;Bertrand Dussol;Juliette Duthoit;Xavier Duval;Anne Margarita Dyrhol-Riise;Sim Choon Ean;Marco Echeverria-Villalobos;Eleanor Edwards;Siobhan Egan;Mohammed El Sanharawi;Subbarao Elapavaluru;Brigitte Elharrar;Philippine Eloy;Tarek Elshazly;Isabelle Enderle;Tomoyuki Endo;Chan Chee Eng;Ilka Engelmann;Vincent Enouf;Olivier Epaulard;Martina Escher;Mariano Esperatti;Hélène Esperou;Catarina Espírito Santo;Marina Esposito-Farese;João Estevão;Manuel Etienne;Nadia Ettalhaoui;Anna Greti Everding;Mirjam Evers;Marc Fabre;Isabelle Fabre;Amna Faheem;Arabella Fahy;Cameron J Fairfield;Pedro Faria;Hanan Fateena;Arie Zainul Fatoni;Karine Faure;Raphaël Favory;Mohamed Fayed;Niamh Feely;Laura Feeney;Jorge Fernandes;Marília Andreia Fernandes;Susana Fernandes;François-Xavier Ferrand;Eglantine Ferrand Devouge;Joana Ferrão;Mário Ferraz;Sílvia Ferreira;Bernardo Ferreira;Benigno Ferreira;Nicolas Ferriere;Céline Ficko;Claudia Figueiredo-Mello;Juan Fiorda;Thomas Flament;Emily Flanagan;Clara Flateau;Tom Fletcher;Aline-Marie Florence;Letizia Lucia Florio;Deirdre Flynn;Jean Foley;Victor Fomin;Tatiana Fonseca;Simon Forsyth;Denise Foster;Giuseppe Foti;Erwan Fourn;Robert A Fowler;Marianne Fraher;Diego Franch-Llasat;John F Fraser;Christophe Fraser;Marcela Vieira Freire;Ana Freitas Ribeiro;Caren Friedrich;Ricardo Fritz;Stéphanie Fry;Nora Fuentes;Masahiro Fukuda;Argin G;Valérie Gaborieau;Rostane Gaci;Massimo Gagliardi;Jean-Charles Gagnard;Amandine Gagneux-Brunon;Sérgio Gaião;Linda Gail Skeie;Phil Gallagher;Carrol Gamble;Yasmin Gani;Arthur Garan;Rebekha Garcia;Noelia García Barrio;Esteban Garcia-Gallo;Denis Garot;Valérie Garrait;Nathalie Gault;Aisling Gavin;Anatoliy Gavrylov;Alexandre Gaymard;Johannes Gebauer;Eva Geraud;Louis Gerbaud Morlaes;Nuno Germano;Jade Ghosn;Marco Giani;Jess Gibson;Tristan Gigante;Morgane Gilg;Elaine Gilroy;Guillermo Giordano;Michelle Girvan;Valérie Gissot;Daniel Glikman;Petr Glybochko;Eric Gnall;François Goehringer;Jean-Christophe Goffard;Jin Yi Goh;Jonathan Golob;Marie Gominet;Alicia Gonzalez;Patricia Gordon;Isabelle Gorenne;Conor Gormley;Laure Goubert;Cécile Goujard;Tiphaine Goulenok;Margarite Grable;Edward Wilson Grandin;Pascal Granier;Giacomo Grasselli;Christopher A Green;William Greenhalf;Segolène Greffe;Domenico Luca Grieco;Matthew Griffee;Fiona Griffiths;Ioana Grigoras;Albert Groenendijk;Heidi Gruner;Yusing Gu;Jérémie Guedj;Martin Guego;Dewi Guellec;Daniela Guerreiro;Romain Guery;Anne Guillaumot;Laurent Guilleminault;Maisa Guimarães de Castro;Thomas Guimard;Marieke Haalboom;Daniel Haber;Hannah Habraken;Ali Hachemi;Nadir Hadri;Sheeba Hakak;Adam Hall;Matthew Hall;Sophie Halpin;Ansley Hamer;Raph L Hamers;Rebecca Hamidfar;Terese Hammond;Naomi Hammond;Lim Yuen Han;Kok Wei Hao;Hayley Hardwick;Ewen M Harrison;Janet Harrison;Alan Hartman;Junaid Hashmi;Ailbhe Hayes;Leanne Hays;Jan Heerman;Lars Heggelund;Ross Hendry;Martina Hennessy;Maxime Hentzien;Diana Hernandez;Andrew Hershey;Liv Hesstvedt;Eibhlin Higgins;Dawn Higgins;Rupert Higgins;Rita Hinchion;Samuel Hinton;Hiroaki Hiraiwa;Hikombo Hitoto;Antonia Ho;Yi Bin Ho;Alexandre Hoctin;Isabelle Hoffmann;Wei Han Hoh;Oscar Hoiting;Rebecca Holt;Jan Cato Holter;Peter Horby;Kota Hoshino;Ikram Houas;Catherine L Hough;Stuart Houltham;Jimmy Ming-Yang Hsu;Jean-Sébastien Hulot;Abby Hurd;Samreen Ijaz;M Arfan Ikram;Hajnal-Gabriela Illes;Patrick Imbert;Hugo Inácio;Yun Sii Ing;Mariachiara Ippolito;Sarah Isgett;Tiago Isidoro;Nadiah Ismail;Margaux Isnard;Junji Itai;Daniel Ivulich;Danielle Jaafar;Salma Jaafoura;Julien Jabot;Clare Jackson;Pierre Jaquet;Waasila Jassat;Coline Jaud-Fischer;Stéphane Jaureguiberry;Florence Jego;Anilawati Mat Jelani;Synne Jenum;Ong Yiaw Joe;Ruth N Jorge García;Mark Joseph;Cédric Joseph;Mercé Jourdain;Philippe Jouvet;Anna Jung;Dafsah Juzar;Ouifiya Kafif;Florentia Kaguelidou;Neerusha Kaisbain;Thavamany Kaleesvran;Sabina Kali;Smaragdi Kalomoiri;Muhammad Aisar Ayadi Kamaluddin;Zul Amali Che Kamaruddin;Nadiah Kamarudin;Darshana Hewa Kandamby;Chris Kandel;Kong Yeow Kang;Pratap Karpayah;Christiana Kartsonaki;Daisuke Kasugai;Anant Kataria;Kevin Katz;Aasmine Kaur;Christy 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Williams;Virginie Williams;Patricia J Williams;Evert-Jan Wils;Jessica Wittman;Calvin Wong;Xin Ci Wong;Yew Sing Wong;Teck Fung Wong;Gan Ee Xian;Lim Saio Xian;Pei Xuan Kuan;Ioannis Xynogalas;Siti Rohani Binti Mohd Yakop;Masaki Yamazaki;Elizabeth Yarad;Yazdan Yazdanpanah;Nicholas Yee Liang Hing;Cécile Yelnik;Chian Hui Yeoh;Stephanie Yerkovich;Toshiki Yokoyama;Hodane Yonis;Obada Yousif;Akram Zaaqoq;Marion Zabbe;Masliza Zahid;Maram Zahran;Nor Zaila Binti Zaidan;Maria Zambon;Miguel Zambrano;Alberto Zanella;Nurul Zaynah;Hiba Zayyad;Alexander Zoufaly;David Zucman

2023

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 na-tions where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes.

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	Parole chiave
	
				acute kidney injury; community-acquired AKI; country income; COVID-19; dialysis; in-hospital death
			
	Settori scientifico-disciplinari dell'articolo (validi dal 09/05/2024)
	
				Settore MEDS-23/A - Anestesiologia
			
	Data di pubblicazione
	
				2023
			
	Rivista in ANCE
	
				KIDNEY INTERNATIONAL REPORTS
			
	DOI
	
				https://dx.doi.org/10.1016/J.EKIR.2023.05.015
			
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				01 - Articolo su periodico

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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1190617

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