Critically Ill Covid-19 Patients at High Risk of Acute Kidney Injury

Critically ill COVID-19 patients are at very high risk of developing acute kidney injury (AKI).

This was the main finding of a study that was conducted at the University Hospital of the West Indies (UHWI) Intensive Care Unit (ICU) from March 2020 to November 2021.

The retrospective study, titled ‘The Prevalence of Acute Kidney Injury and Mortality in COVID-19 Patients Admitted to the University Hospital of the West Indies Intensive Care Unit’, was conducted on patients who entered hospital during the height of the COVID-19 pandemic.

Speaking in an interview with JIS News, Director of the Critical Care Unit at the UHWI, Dr. Patrick Toppin, explained that the objective of the study was to determine the prevalence of and risk factors for AKI in patients with COVID-19.

Dr. Toppin, who is also an intensivist and anaesthesist, conducted the study along with then resident Dr. Gabrielle Scarlett, who was satisfying a requirement for her specialisation in anaesthesia, which she has since completed.

The study was presented at the 2022 National Health Research Conference and won the award for Best Student Oral Presentation.

Dr. Toppin explained that the research was aimed at assessing the predictors that determined how well patients did and also served as an assessment of the overall ICU system at the UHWI.

The team used data from 156 patients with an average age of 55, of which just under 60 per cent were male.

There was a high burden of comorbidity, including obesity, diabetes and hypertension.

“About 80 per cent of our patients had some comorbidity. We were able to map the effects of different waves in terms of how our patients did. When we had the Delta wave, that was by far the worst period,” Dr. Toppin said, adding that a little more than 60 per cent of patients did not survive.

The Critical Care Unit director pointed out that the average patient spent approximately two weeks in ICU and about two thirds of them had some kidney injury.

“About 80 per cent ended up on a ventilator and required cardiovascular medications to support their blood pressure. UHWI had almost all of the critically ill ICU spaces in Jamaica, and while there were one or two patients housed at other places, in a lot of ways, it represented the patients that made it into ICU in Jamaica,” Dr. Toppin pointed out.