Outcomes of COVID-19 in Cancer Patients who Developed Acute Kidney Injury During Hospitalization in a Tertiary Care Hospital in India

Ram Singh; Hari Krishna Raju Sagiraju; Sudarsan Krishnasamy; Prashant Sirohiya; Balbir Kumar; Brajesh Kumar Ratre; Sushma Bhatnagar

doi:10.31557/apjcc.2022.7.3.515-517

Authors

Ram Singh Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R.A.I.R.C.H. & N.C.I., All India Institute of Medical Sciences, New Delhi, India.
Hari Krishna Raju Sagiraju Department of Preventive Oncology, N.C.I., Jhajjar, All India Institute of Medical Sciences, New Delhi, India.
Sudarsan Krishnasamy 3 Department of Pediatric Nephrology, All India Institute of Medical Sciences, New Delhi, India.
Prashant Sirohiya Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R.A.I.R.C.H. & N.C.I., All India Institute of Medical Sciences, New Delhi, India.
Balbir Kumar Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R.A.I.R.C.H. & N.C.I., All India Institute of Medical Sciences, New Delhi, India.
Brajesh Kumar Ratre Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R.A.I.R.C.H. & N.C.I., All India Institute of Medical Sciences, New Delhi, India.
Sushma Bhatnagar Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R.A.I.R.C.H. & N.C.I., All India Institute of Medical Sciences, New Delhi, India.

DOI:

https://doi.org/10.31557/apjcc.2022.7.3.515-517

Keywords:

Acute Kidney Injury; Cancer; COVID-19; Kidney Disease: Improving Global Outcomes

Abstract

Background: The development of acute kidney injury (AKI) in patients infected with COVID-19 has been observed to be associated with poor outcomes. Our study aimed to measure the outcomes of COVID-19 in cancer patients who developed AKI during hospitalization and the predictive baseline clinical and laboratory factors associated with the development of AKI.
Materials and Methods: This retrospective cohort study was conducted at a COVID hospital that included only cancer patients with COVID-19 infection. Acute kidney injury (AKI) was defined according to KDIGO (Kidney Disease: Improving Global Outcomes) criteria. The demographic, clinical, laboratory and outcomes data were collected from the hospital electronic database and abstracted from the case files.
Results: Thirteen (12.8%) of the total 102 cancer patients developed AKI during hospitalization. Out of 13, 11 (84.6%) patients presented with hypoxemia during admission and required oxygen support. Breathlessness [Odds Ratio (OR) (95% CI): 5.8 (1.1-31.3)] or hypoxemia [OR 22.6 (2.6-194.5)] at the time of presentation and requirement of oxygen support [OR 7.5 (1.4-40.5)] were significantly associated with AKI after adjusting for age, gender, vaccination status and comorbidities. Median baseline values of inflammatory markers were significantly higher among those who developed AKI. Out of 102, 27 (26.5%) patients had in-hospital mortality. Mortality was high among those who developed AKI compared to those who didn’t develop AKI (92.3% vs 16.1%, p-value: <0.001).
Conclusions: The cancer patients infected by COVID-19 and who developed AKI were more vulnerable to poor outcomes in terms of in-hospital mortality. The patients with severe disease at presentation and higher levels of baseline inflammatory markers CRP, ferritin, and D-Dimer were more susceptible to the development of AKI and in turn, led to a higher risk of in-hospital mortality in these patients.