Immunological, biochemical, and hematological aspects of acute kidney injury in severe/critical COVID-19 patients

Document Type : Original Article


1 Department of Microbiology, Al-Shomali General Hospital, Babylon Health Directorate, Babylon, Iraq

2 Department of Medical Laboratory Technology, College of Medical Technology, The Islamic University, Najaf, Iraq


Background: COVID-19 has become a global pandemic. Infection is primarily a respiratory illness, but other organs such as the kidneys may be affected. This study aimed to evaluate the incidence of acute kidney injury (AKI) in patients with COVID-19 associated with different parameters. Materials and methods: This prospective study was performed on 125 patients with severe/ critical COVID-19 hospitalized in respiratory care unit of Marjan medical city, Babylon, Iraq between January and June 2022. Laboratory investigations including immunological, biochemical, and hematological parameters as well as demographic information and chest computed tomography (CT) scan findings were gathered from the patient’s records. According to Kidney Disease Improving Global Outcomes criteria, patients were grouped with and without AKI. Results: Of 125 patients admitted with severe/ critical Covid-19, AKI developed in 39 (31.2 %).  Incidence of AKI had a significant differences compared with Non-AKI patients regarding age (p= 0.009), SpO2 (p= 0.006), and CT scan (P= 0.001). Lactate dehydrogenase increased in AKI group 729 (504- 793) U/L compared to Non-AKI group 325 (220- 671) U/L significantly (P< 0.001). As well as, ferritin increased in patients with AKI (P= 0.01). Other inflammatory parameters including IL-35, presepsin, C- reactive protein, and D-dimer revealed no significant differences (P>0.05). Serum urea, creatinine, and potassium were significantly increased in patients with AKI (P< 0.001). Whereas calcium and total protein were decreased in AKI group significantly (P= 0.006 and P= 0.004) respectively. In AKI patients there was significantly increased in erythrocyte sedimentation rate (P= 0.022), white blood cell (P= 0.033), and granulocytes (P< 0.001). Platelets and lymphocytes were decreased in AKI group (P= 0.011 and P=0.001) respectively. Conclusion: These investigated parameters may be considered as good indicators for the possibility of AKI in patients with COVID-19. Clinical practice and further research are recommended based on these findings.


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