Omicron surge impact on acute kidney injury in ICU patients: A study using the ISARIC COVID-19 database
Abstract
BACKGROUND: Acute Kidney Injury (AKI) is common among COVID-19 patients and is associated with a higher risk of death. Compared to earlier COVID-19 variants, Omicron has reduced mortality. To study the relationship between Omicron and AKI, we conducted the first international study using the global International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 global dataset.
METHODS: This prospective observational study aims to characterise AKI in a cohort of 3,908 COVID-19 patients admitted to the intensive care unit (ICU) across six countries. Clinical characteristics were compared between Omicron and pre-Omicron patients. Multivariable logistic regression was used to analyse the relationship between the Omicron variant and AKI. AKI was defined based on the change in serum creatinine levels, in accordance with the Kidney Disease Improving Global Outcome AKI guidelines.
RESULTS: Patients admitted to an ICU during the Omicron wave were older and had more comorbidities than pre-Omicron patients. The prevalence of AKI was the same between Omicron and previous variants (24.7% vs 22.9%, p-value = 0.321). Controlling for confounders, ICU patients with the Omicron variant were 30%-40% less likely to develop AKI compared to patients with previous variants. The survival curves between AKI patients with Omicron and non-Omicron variants were consistent with the survival analysis.
CONCLUSION: After adjusting for demographics, comorbidities, laboratory…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 19 participants or records.
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