Predictors of AKI in VA Patients With COVID-19

Information about AKI among patients with COVID-19 is lacking. To fill the knowledge gap, Lilia R. Lukowsky and colleagues used logistic regression models to examine predictors of AKI among a population of US veterans and also performed a survival analysis to study mortality in patients with COVID-19. The study involved 742,799 patients, of whom 95,573 were hospitalized within 60 days of a COVID-19 diagnosis.  

The following factors were associated with AKI: use of vasopressors (OR, 14.73; 95% confidence limit [CL], 13.96-15.53), history of AKI (OR, 2.22; 95% CL, 2.15-2.29), male gender (OR, 1.90; 95% CL, 1.75-2.05), Black race (OR, 1.62; 95% CL, 1.57-1.65), and age ≥65 years (OR, 1.57; 95% CL, 1.50-1.63).  

Patients who were vaccinated against COVID-19 twice and had received boosters were the least likely to develop AKI (OR, 0.51; 95% CL, 0.49-0.53) compared to unvaccinated COVID-19 patients. Those who had two doses (OR, 0.77; 95% CL, 0.72-0.81) or a single dose (OR, 0.88; 95% CL, 0.81-0.95) were also less likely to develop AKI compared to unvaccinated patients.  

Patients with AKI had four times higher mortality compared to those without AKI (HR, 4.35; 95% CL, 4.23-4.50). Vaccinated and boosted patients had the lowest mortality risk compared to unvaccinated patients (HR, 0.30; 95% CL, 0.28-0.31).  

Vasopressor use, unvaccinated status, older age, male gender, and Black race were associated with AKI post–COVID-19. However, it is unclear whether COVID-19 vaccination, including boosters, lessens the risk of developing AKI. 

Source: Vaccines