Acute renal failure in COVID-19 patients on mechanical ventilation

Abstract

Introduction: COVID-19 Community acquired pneumonia is a recent and frequent cause of admission in European intensive care units. Currently, there are many open questions regarding the management and prognostic factors of these patients. Among them, its association with acute renal failure in patients on mechanical ventilation. Objetive: Analysis of acute renal failure in COVID-19 patients on mechanical ventilation. Prognosis and factors related to its development. Material and Methods: Retrospective observational study carried out in the intensive care unit of a University Hospital during the COVID-19 pandemic. We analysed patients admitted to the ICU with the diagnosis of Respiratory Failure due to Pneumonia COVID-19 between 6/3/2020 and 21/4/2020. Demographic data (age, sex), APACHE II, comorbidities, analytical data (ferritin, total bilirubin), length of stay, treatments administered (mechanical ventilation, muscle relaxant, vasoactive drugs, prone) and its association to acute renal failure were analysed. Results: 67 patients received complete treatment in our hospital. Length of stay (days) 14.1 ± 10, average age 60 years, APACHE II 14.3 ± 5.2, 67.2% males. Maximum creatinine mean value (mg/dl) 1.48 ± 1.26, Maximum ferritin mean value (ng/ml) 2,310 ± 3,322, Maximum total bilirubin mean value (mg/dl) 2 ± 2.2. 100% of the patients required mechanical ventilation. 65.7% prone positioning, 74.6% neuromuscular blockers and 98.5% required vasoactive drugs. Establishing renal failure as creatinine values greater than 1.2 mg/dl. Patients with maximum creatinine above 1.2 mg/dl presented average values of bilirubin and ferritin higher than those with values under 1.2 mg/dl (P < 0.05). The presence of renal failure was also statistically significantly associated with sex (male), presence of dyslipidaemia, and mortality. Conclusions: In our sample, we have associated acute renal failure with higher ferritin values. Likewise, we have observed higher creatinine values in the group of non-survivors, those with dyslipidaemia and men, with statistical signification.