Archive \ Volume.13 2022 Issue 2

Pharmacotherapeutic Evaluation of Covid-19 Patients Suffering from Acute Kidney Injury

Muhammad Osama Yaseen, Misha Yaseen, Tahir Mehmood Khan, Inayat Rehman, Amal K. Suleiman, Mirza Rafi Baig, Ammar A. Jaber, Ahmed Telb, Farah Nofal Alnafoosi

The risk of developing Acute Kidney Injury (AKI) increases manifold during severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Therefore, the aim of this study is to conduct a comprehensive pharmacotherapeutic evaluation of AKI in COVID-19 patients. A retrospective cohort study was conducted from July to August 2021 among COVID-19 patients admitted to the Institute of Kidney Diseases, Hayatabad Medical Complex hospital in Peshawar Pakistan. The data were extracted based on demographics, diagnosis, laboratory parameters, vital signs, and the treatment used during hospitalization. The association of independent variables was explored using parametric statistics such as regression analysis, one-way ANOVA, and Kruskal-Wallis. Data of N=595 COVID-19 patients with positive PCR tests as per pre-defined criteria were collected. It was observed that fever (n=575 [96.6%]), shortness of breath (n=570 [95.8%]), dry cough (n=449 [75.5%]) and body aches (n=129 [21.7%]) were some of the most common symptoms among the patients. Most of the patients were on a multi-drug regimen during hospitalization. Overall, it was observed that most of the laboratory variables significantly declined in COVID-19 patients with Stage III AKI. Mortality among the patients with AKI was 42% [0.418 [0.269 – 0.632], p=<0.001] as compared to non-AKI patients. There was a significant reduction in mortality by 96% (1.968 [1.277 – 3.033], p-0.002) with the use of intravenous dexamethasone. The prime goal of a clinician is to avoid the use of nephrotoxic drugs during hospitalization and maintain adequate oxygen saturation in order to avoid the development of AKI in COVID-19 patients.

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How to cite:
Yaseen MO, Yaseen M, Khan TM, Rehman I, Suleiman AK, Baig MR, et al. Pharmacotherapeutic Evaluation of Covid-19 Patients Suffering from Acute Kidney Injury. Arch Pharm Pract. 2022;13(2):78-87.
Yaseen, M. O., Yaseen, M., Khan, T. M., Rehman, I., Suleiman, A. K., Baig, M. R., Jaber, A. A., Telb, A., & Alnafoosi, F. N. (2022). Pharmacotherapeutic Evaluation of Covid-19 Patients Suffering from Acute Kidney Injury. Archives of Pharmacy Practice, 13(2), 78-87.

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1.        Velavan TP, Meyer CG. The COVID‐19 epidemic. Trop Med Int Health. 2020;25(3):278.

2.        Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. J Adv Res. 2020;24:91-8.

3.        Mo P, Xing Y, Xiao Y, Deng L, Zhao Q, Wang H, et al. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Clin Infect Dis. 2020.

4.        Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.

5.        Chen B, Liu M, Huang C. Current diagnostic and therapeutic strategies for COVID-19. J Pharm Anal. 2021;11(2):129-37.

6.        Lim MA, Pranata R, Huang I, Yonas E, Soeroto AY, Supriyadi R. Multiorgan failure with emphasis on acute kidney injury and severity of COVID-19: systematic review and meta-analysis. Can J Kidney Health Dis. 2020;7:2054358120938573.

7.        Saraladevi N, Chih-Wei Y, Shang-Jyh H, Bi-Cheng L, Jiang-Hua C, Vivekanand J. The Novel Coronavirus 2019 epidemic and kidneys. Kidney Int. 2020;97(5):824-28.

8.        Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020;97(5):829-38.

9.        Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Infect Dis. 2020;94(1):91-5.

10.      Ghani RA, Zainudin S, Ctkong N, Rahman AF, Wafa SR, Mohamad M, et al. Serum IL‐6 and IL‐1‐ra with sequential organ failure assessment scores in septic patients receiving high‐volume haemofiltration and continuous venovenous haemofiltration. Nephrology. 2006;11(5):386-93.

11.      Gabarre P, Dumas G, Dupont T, Darmon M, Azoulay E, Zafrani L. Acute kidney injury in critically ill patients with COVID-19. Intensive Care Med. 2020;46(7):1339-48.

12.      Fisher M, Neugarten J, Bellin E, Yunes M, Stahl L, Johns TS, et al. AKI in Hospitalized Patients with and without COVID-19: A Comparison Study. J Am Soc Nephrol. 2020;31(9):2145-57.

13.      Brienza N, Puntillo F, Romagnoli S, Tritapepe L. Acute kidney injury in coronavirus disease 2019 infected patients: a meta-analytic study. Blood Purif. 2021;50(1):35-41.

14.      Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020;97(5):829-38.

15.      Mou Z, Zhang X. AKI during COVID-19 infection: low incidence, high risk of death. medRxiv. 2020.

16.      Cheng Y, Luo R, Wang X, Wang K, Zhang N, Zhang M, et al. The Incidence, Risk Factors, and Prognosis of Acute Kidney Injury in Adult Patients with Coronavirus Disease 2019. Clin J Am Soc Nephrol. 2020;15(10):1394-402.

17.      Yaseen MO, Yaseen M, Khan TM, Jamshaid H, Naveed HMA, Imran MS. A systematic review of systematic reviews on the incidence of acute kidney injury in covid-19 patients. Pharmacophore. 2021:92-102.

18.      Moe S. Kidney disease: improving global outcomes (KDIGO). Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006;69(11):1945-53.

19.      Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.

20.      Khan FS, Lotia-Farrukh I, Khan AJ, Siddiqui ST, Sajun SZ, Malik AA, et al. The burden of non-communicable disease in transition communities in an Asian megacity: baseline findings from a cohort study in Karachi, Pakistan. PloS one. 2013;8(2):e56008.

21.      de Lucena TMC, da Silva Santos AF, de Lima BR, de Albuquerque Borborema ME, de Azevêdo Silva J. Mechanism of inflammatory response in associated comorbidities in COVID-19. Diabetes Metab Syndr. 2020;14(4):597-600.

22.      Bode B, Garrett V, Messler J, McFarland R, Crowe J, Booth R, et al. Glycemic characteristics and clinical outcomes of COVID-19 patients hospitalized in the United States. J Diabetes Sci Technol. 2020;14(4):813-21.

23.      Lippi G, Wong J, Henry BM. Hypertension and its severity or mortality in Coronavirus Disease 2019 (COVID-19): a pooled analysis. Pol Arch Intern Med. 2020;130(4):304-09.

24.      Malik P, Patel U, Mehta D, Patel N, Kelkar R, Akrmah M, et al. Biomarkers and outcomes of COVID-19 hospitalisations: systematic review and meta-analysis. BMJ Evid Based Med. 2021;26(3):107-08.

25.      Liao YC, Liang WG, Chen FW, Hsu JH, Yang JJ, Chang MS. IL-19 induces production of IL-6 and TNF-α and results in cell apoptosis through TNF-α. J Immunol. 2002;169(8):4288-97.

26.      Yang JK, Lin SS, Ji XJ, Guo LM. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol. 2010;47(3):193-99.

27.      Ottestad W, Seim M, Mæhlen JO. COVID-19 with silent hypoxemia. Tidsskr Nor Laegeforen. 2020.

28.      Tian S, Hu W, Niu L, Liu H, Xu H, Xiao SY. Pulmonary pathology of early-phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J Thorac Oncol. 2020;15(5):700-04.

29.      Xie J, Covassin N, Fan Z, Singh P, Gao W, Li G, et al. Association between hypoxemia and mortality in patients with COVID-19. Mayo Clinic Proceedings: Elsevier; 2020. p. 1138-47.

30.      Xu J, Zhao S, Teng T, Abdalla AE, Zhu W, Xie L, et al. Systematic comparison of two animal-to-human transmitted human coronaviruses: SARS-CoV-2 and SARS-CoV. Viruses. 2020;12(2):244.

31.      Mingzhang Z, Yuguang H, Wuhua M, Zhanggang X, Jiaqiang Z, Yahong G, et al. Hochpräzise CNC-BearbeitungsmaschineD7075 6061 Maschinenbearbeitungsteile. Chin Med Sci J. 2020;35(2):105-09.

32.      Yao TT, Qian JD, Zhu WY, Wang Y, Wang GQ. A systematic review of lopinavir therapy for SARS coronavirus and MERS coronavirus—A possible reference for coronavirus disease‐19 treatment option. J Med Virol. 2020;92(6):556-63.

33.      Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020;80(6):e14-8.

34.      Lin C, Ding Y, Xie B, Sun Z, Li X, Chen Z, et al. Asymptomatic novel coronavirus pneumonia patient outside Wuhan: the value of CT images in the course of the disease. Clin Imaging. 2020;63:7-9.

35.      Lafaurie M, Martin-Blondel G, Delobel P, Kamar N, Charpentier S, Sommet A, et al. Impact of previous exposure to systemic corticosteroids on unfavorable outcome in patients hospitalized for COVID-19. BMC Pharmacol Toxicol. 2021;22(1):1-6.

36.      Tomazini BM, Maia IS, Cavalcanti AB, Berwanger O, Rosa RG, Veiga VC, et al. Effect of dexamethasone on days alive and ventilator-free in patients with moderate or severe acute respiratory distress syndrome and COVID-19: the CoDEX randomized clinical trial. JAMA. 2020;324(13):1307-16.

37.      Qian JY, Wang B, Liu BC. Acute kidney injury in the 2019 novel coronavirus disease. Kidney Dis. 2020;6(5):318-23.

38.      Hsu PC, Liu CH, Lee WC, Wu CH, Lee CT, Su CH, et al. Predictors of Acute Kidney Disease Severity in Hospitalized Patients with Acute Kidney Injury. Biomedicines. 2022;10(5):1081.

39.      Chen L, Liu H, Liu W, Liu J, Liu K, Shang J, et al. Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia. Zhonghua Jie He He Hu Xi Za Zhi. 2020;43:E005.

40.      Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-69.

41.      Adapa S, Chenna A, Balla M, Merugu GP, Koduri NM, Daggubati SR, et al. COVID-19 Pandemic Causing Acute Kidney Injury and Impact on Patients with Chronic Kidney Disease and Renal Transplantation. J Clin Med Res. 2020;12(6):352-61.

42.      Selby NM, Forni LG, Laing CM, Horne KL, Evans RD, Lucas BJ, et al. Covid-19 and acute kidney injury in hospital: summary of NICE guidelines. BMJ. 2020;369.

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