Kidney Week

Abstract: TH-PO1144

AKI in Intensive Care Unit (ICU) Patients in the Omicron Surge: Insights from a Multinational Study

Session Information

• COVID-19
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Gois, Pedro Henrique Franca, The University of Queensland, Brisbane, Queensland, Australia

Pedro Henrique Franca Gois, MD, PhD, FASN

• Dai, Danyang, The University of Queensland, Brisbane, Queensland, Australia

Danyang Dai

• Shrapnel, Sally, The University of Queensland, Brisbane, Queensland, Australia

Sally Shrapnel, MBBS, MSc, PhD

• Wainstein, Marina, The University of Queensland, Brisbane, Queensland, Australia

Marina Wainstein, MA, MBBS, PhD

• Ghadimi, Moji, The University of Queensland, Brisbane, Queensland, Australia

Moji Ghadimi

• Spyrison, Nicholas S., The University of Queensland, Brisbane, Queensland, Australia

Nicholas S. Spyrison, PhD

• Claure-Del Granado, Rolando, Universidad Mayor de San Simon, Cochabamba, Cochabamba, Bolivia, Plurinational State of

Rolando Claure-Del Granado, MD, FASN

• Pole, Jason D., The University of Queensland, Brisbane, Queensland, Australia

Jason D. Pole, MSc, PhD

Group or Team Name

• ISARIC Characterization Group.

Background

Acute kidney injury (AKI) is a common and serious complication of COVID-19. Few studies have investigated the prevalence of AKI in patients admitted to Intensive Care Units (ICU) during the Omicron surge. We aim to examine the relationship between AKI and the Omicron variant in critically ill patients using the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 global dataset.

Methods

This is a prospective observational study of COVID-19 patients admitted to ICU across 6 countries between June 2021 and October 2022. AKI was defined as per KDIGO serum creatinine (sCr) criteria within 7 days of hospitalization, using the first available sCr as baseline. Patients were categorized into "Pre-Omicron" (before Dec 1, 2021) and "Omicron" (after Jan 1, 2022). Multivariable logistic regression was used to analyze the association between Omicron and AKI.

Results

The analysis included 3,908 patients (3,203 pre-Omicron, 705 Omicron). AKI distribution by countries/variants is shown in Figure 1A. AKI prevalence and dialysis were not different between Omicron and prior variants (24.7% vs 22.9%, p=0.32; and 45% vs. 52%, p=0.15, respectively). Most patients had stage 3 AKI (Figure 1B). Patients in the Omicron wave were older and had more comorbidities. After adjusting for confounders, Omicron patients were ~40% less likely to develop AKI compared to prior variants. Survival curves for AKI patients showed no significant differences between Omicron and prior variants (Figure 2).

Conclusion

Patients hospitalized during the Omicron wave were less likely to develop AKI compared to previous eras, highlighting the importance of continued research to elucidate the evolving characteristics of the disease.

Funding

• Government Support – Non-U.S.