Predictors of in-hospital mortality among hospitalized patients with COVID-19 and AKI: A single-center study

Background: AKI and COVID-19 infection are both independently associated with high mortality rates and those with COVID-19 who develop AKI have higher mortality rates. We investigated the predictors of mortality in patients admitted to our hospital with COVID-19 who developed AKI during their hospital stay. Methods: We conducted a retrospective analysis of all patients hospitalized at University of Virginia Medical Center for COVID-19 infection who developed AKI from March 2020 through April 2021. In-hospital mortality was defined as death during admission or within 7 days of discharge to hospice. Data on patients' demographics, comorbidities, AKI stage, dialysis requirement, admission to ICU, serum albumin, ferritin, d-dimer, fibrinogen, hemoglobin, as well as mortality at hospital discharge and 90 days were collected through chart review. Univariate analysis and a multivariate logistic regression model were used to identify factors associated with in-hospital mortality. Results: 219 patients qualified for study inclusion criteria. The average age was 66.2 years and 56.6% of patients were men. The in-hospital mortality rate was 27.9%. An additional 1.37% died in the 90-day follow-up period. Age (p = 0.001), male sex (p = 0.049), AKI-D (p < 0.001), AKI stage (p < 0.001), serum albumin (p < 0.001), and ICU admission (p < 0.001) were associated with mortality in the univariate analysis (Table 1). After adjustments for covariates, age (p < 0.001), AKI-D (p = 0.001), and ICU admission (p < 0.001) were predictors of mortality in our multivariate analysis [AUC: 0.863, 95% CI (0.815-0.911)]. Conclusions: Age, dialysis requirement, severity of AKI, and ICU admission are predictors of mortality among patients with COVID-19 and AKI at our institution.