Clinical Features and Prognosis of Acute Kidney Injury in Hospital-Admitted Patients with COVID-19 in Egypt: A Single-Center Experience
et al., Mansoura Medical Journal, doi:10.58775/2735-3990.1433, Jan 2025
Retrospective 236 hospitalized COVID-19 patients showing favipiravir use associated with increased risk of acute kidney injury (AKI). AKI was associated with higher mortality.
Potential risks of favipiravir include kidney injury1-3, liver injury2-4, and mutagenicity, carcinogenicity, teratogenicity, embryotoxicity, and the creation of dangerous variants5-11.
|
AKI, 148.7% higher, OR 2.49, p = 0.03, treatment 57, control 179, RR approximated with OR.
|
| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
1.
Abdulaziz et al., Clinical Features and Prognosis of Acute Kidney Injury in Hospital-Admitted Patients with COVID-19 in Egypt: A Single-Center Experience, Mansoura Medical Journal, doi:10.58775/2735-3990.1433.
2.
Ülger et al., Experimental evaluation of favipiravir (T-705)-induced liver and kidney toxicity in rats, Food and Chemical Toxicology, doi:10.1016/j.fct.2025.115472.
3.
El-Fetouh et al., Experimental Studies on Some Drugs Used in Covid-19 Treatment (Favipiravir and Dexamethasone) in Albino Rats, Journal of Advanced Veterinary Research, 13:10, www.advetresearch.com/index.php/AVR/article/view/1635.
4.
Almutairi et al., Liver Injury in Favipiravir-Treated COVID-19 Patients: Retrospective Single-Center Cohort Study, Tropical Medicine and Infectious Disease, doi:10.3390/tropicalmed8020129.
5.
Zhirnov et al., Favipiravir: the hidden threat of mutagenic action, Journal of microbiology, epidemiology and immunobiology, doi:10.36233/0372-9311-114.
6.
Waters et al., Human genetic risk of treatment with antiviral nucleoside analog drugs that induce lethal mutagenesis: the special case of molnupiravir, Environmental and Molecular Mutagenesis, doi:10.1002/em.22471.
7.
Hadj Hassine et al., Lethal Mutagenesis of RNA Viruses and Approved Drugs with Antiviral Mutagenic Activity, Viruses, doi:10.3390/v14040841.
8.
Shum, C., An investigational study into the drug-associated mutational signature in SARS-CoV-2 viruses, The University of Hong Kong, PhD Thesis, hub.hku.hk/handle/10722/344396.
9.
Shiraki et al., Convenient screening of the reproductive toxicity of favipiravir and antiviral drugs in Caenorhabditis elegans, Heliyon, doi:10.1016/j.heliyon.2024.e35331.
Abdulaziz et al., 1 Jan 2025, retrospective, Egypt, peer-reviewed, median age 68.5, 3 authors, study period September 2020 - February 2021.
Contact: hodamma@mans.edu.eg, hodamma@yahoo.com.
Clinical Features and Prognosis of Acute Kidney Injury in Hospital-Admitted Patients with COVID-19 in Egypt: A Single-Center Experience
Mansoura Medical Journal, doi:10.58775/2735-3990.1433
Background: While coronavirus disease 2019 primarily manifests clinically as a respiratory disease, it can also impact other organs, such as the kidneys. Acute kidney injury (AKI) is frequently seen in hospital-admitted patients with COVID-19 and is linked to poorer outcomes. This research sought to explore the rate, contributing elements, and consequences of AKI in individuals with COVID-19. Patients and methods: Data from 236 COVID-19-infected patients hospitalized in isolation wards and ICUs between September 2020 and February 2021 were analyzed. Comparisons between patients with and without AKI were done using statistical tests as appropriate. Binary logistic regression analyses were performed at the univariable and multivariable levels to identify the risk factors for AKI. Survival data based on AKI status was analyzed using the KaplaneMeier curve. Results: Overall, 81 (34.3 %) of the 236 participants developed AKI during hospitalization. Hospitalized COVID-19 individuals with age more than 64 years, those who received Favipiravir or vasopressors, and those with pH less than or equal to 7.4, HCO3 less than or equal to 19.2, and blood glucose more than 212 mg/dl have 2.4, 2.5, 2.4, 3.4, 3.2, and 2.9times higher odds to exhibit AKI. A significantly lower survival probability was found in individuals with AKI than in non-AKI [log-rank c 2 (2) ¼ 41.187, P < 0.001]. A shorter median survival time for patients with AKI compared with those without was also noticed [8 days (95 % confidence interval: 7.132e8.868) vs. 12 days (95 % confidence interval: 10.910e13.090)]. Conclusion: AKI is not uncommonly encountered in patients with COVID-19 in the course of their hospitalization and is linked to increased mortality.
Ethics information The Mansoura Faculty of Medicine Institutional Research Board (MFM-IRB) (code MS.22.08.2103)
Conflicts of interest There are no conflicts of interest.
References
Batlle, Soler, Sparks, Hiremath, South et al., Acute kidney injury in COVID-19: Emerging evidence of a distinct pathophysiology, J. Am. Soc. Nephrol
Bialek, Boundy, Bowen, Chow, Cohn et al., Severe outcomes among patients with coronavirus disease 2019 (COVID-19)-United States, CDC Covid-19 Response Team
Cheng, Luo, Wang, Zhang, Wang et al., Kidney disease is associated with in-hospital death of patients with COVID-19, Kidney Int
El-Sayed, Allayeh, Salem, Omar, Zaghlol et al., Incidence of acute kidney injury among COVID-19 patients in Egypt, Ren. Replace Ther
Han, Ye, Kidney involvement in COVID-19 and its treatments, J. Med. Virol
Hansrivijit, Gadhiya, Gangireddy, Goldman, Risk factors, clinical characteristics, and prognosis of acute kidney injury in hospitalized COVID-19 patients: a retrospective cohort study, Medicines
Hirsch, Ng, Ross, Sharma, Shah et al., Acute kidney injury in patients hospitalized with COVID-19, Kidney Int
Huang, Wang, Li, Ren, Zhao et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet
Jewell, Bramham, Galloway, Post, Norton et al., COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort, BMC Nephrol
Kasem, Kora, Emara, Mohamed, Acute kidney injury in hospitalized patients with COVID-19, Menoufia Med. J
Khwaja, KDIGO clinical practice guidelines for acute kidney injury, Nephron Clin. Pract
Madbouli, Arif, Faheem, Incidence and prognosis of acute kidney injury with COVID-19 in hospitalized Egyptian patients, Egypt J. Hosp. Med
Rakha, Tawfik, Mahmoud, Keshawy, Acute kidney injury in coronavirus disease 2019 patients: a game modifier, J. Egypt Soc. Nephrol. Transplant
Refat, Kasem, Kamel, Mady, Local experience on clinical characteristics of COVID-19: Single center experience, Egypt J. Hosp. Med
Sharma, Ng, Bijol, Jhaveri, Wanchoo, Pathology of COVID-19-associated acute kidney injury, Clin. Kidney J
Silver, Beaubien-Souligny, Shah, Harel, Blum et al., The prevalence of acute kidney injury in patients hospitalized with COVID-19 infection: A systematic review and meta-analysis, Kidney Med
William, Sharaf, Ismail, Clinical and pathological renal outcomes of COVID-19 patients: an Egyptian retrospective multi-center pooled analysis, Egypt J. Intern. Med
DOI record:
{
"DOI": "10.58775/2735-3990.1433",
"ISSN": [
"2735-3990"
],
"URL": "http://dx.doi.org/10.58775/2735-3990.1433",
"author": [
{
"affiliation": [],
"family": "Abdulaziz",
"given": "Hoda M. M.",
"sequence": "first"
},
{
"affiliation": [],
"family": "Elsayed",
"given": "Aya Ahmed Mohamed",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Yousef",
"given": "Elshahat A.",
"sequence": "additional"
}
],
"container-title": "Mansoura Medical Journal",
"container-title-short": "Mansoura Medical Journal",
"content-domain": {
"crossmark-restriction": false,
"domain": []
},
"created": {
"date-parts": [
[
2025,
5,
8
]
],
"date-time": "2025-05-08T10:37:49Z",
"timestamp": 1746700669000
},
"deposited": {
"date-parts": [
[
2025,
5,
8
]
],
"date-time": "2025-05-08T10:37:49Z",
"timestamp": 1746700669000
},
"indexed": {
"date-parts": [
[
2025,
5,
8
]
],
"date-time": "2025-05-08T11:10:10Z",
"timestamp": 1746702610809,
"version": "3.40.5"
},
"is-referenced-by-count": 0,
"issue": "1",
"issued": {
"date-parts": [
[
2025,
1,
1
]
]
},
"journal-issue": {
"issue": "1",
"published-online": {
"date-parts": [
[
2025,
1,
1
]
]
}
},
"language": "en",
"member": "37388",
"original-title": [],
"prefix": "10.58775",
"published": {
"date-parts": [
[
2025,
1,
1
]
]
},
"published-online": {
"date-parts": [
[
2025,
1,
1
]
]
},
"publisher": "Mansoura University",
"reference-count": 0,
"references-count": 0,
"relation": {},
"resource": {
"primary": {
"URL": "https://mmj.mans.edu.eg/home/vol54/iss1/1"
}
},
"score": 1,
"short-title": [],
"source": "Crossref",
"subject": [],
"subtitle": [],
"title": "Clinical Features and Prognosis of Acute Kidney Injury in Hospital-Admitted Patients with COVID-19 in Egypt: A Single-Center Experience",
"type": "journal-article",
"volume": "54"
}
Late treatment
is less effective
is less effective
