Acute kidney injury linked to mortality in hospitalized COVID-19 cohort

Acute kidney injury occurred in 140 of 435 adults hospitalized with confirmed COVID-19 in a retrospective two-center study in East Jerusalem, and its presence was associated with substantially higher odds of death. The researchers analyzed patients admitted to Al-Makassed Hospital and Augusta Victoria Hospital from March 2020 through March 2022, staging kidney injury according to Kidney Disease: Improving Global Outcomes criteria. Among patients who developed acute kidney injury, 63.6% experienced renal recovery and 35.7% died. Acute kidney injury was associated with mortality with an odds ratio of 3.5 and a 95% confidence interval of 2.16–5.66.

The cohort included 435 adults with confirmed SARS-CoV-2 infection, making it a bi-center observational study rather than an intervention trial. Most acute kidney injury cases were in men, who accounted for 60% of the affected group, and 74.3% of cases occurred among patients older than 60. Severe COVID-19 was present in 70.7% of patients with kidney injury, while 45% required admission to an intensive care unit. The analysis also identified invasive ventilation, higher inflammatory markers, elevated lactate, and increased peak creatinine and blood urea nitrogen as independent mortality predictors. Because the study was retrospective, its regression results identify associations and cannot establish that any of these factors directly caused death.

Kidney injury was graded into three stages: stage 1 occurred in 60% of affected patients, stage 2 in 21.4%, and stage 3 in 18.6%. A higher acute kidney injury stage was associated with poorer renal outcomes and increased mortality, with the relationship reported at p<0.001. The investigators used multivariable logistic regression to assess predictors of acute kidney injury and mortality. Overall, the findings connect the risk of kidney injury during hospitalization with both the clinical severity of COVID-19 and the intensity of organ support, particularly intensive care admission and invasive mechanical ventilation.

For the 140 patients classified as having acute kidney injury, renal recovery was observed in 63.6%, while death occurred in 35.7%. These outcomes indicate that kidney function did not recover in every affected patient, although the abstract does not provide the follow-up duration, definitions used for recovery, or complete clinical characteristics of those who recovered versus died. The study population was restricted to adults admitted to two hospitals in East Jerusalem during the first two years of the pandemic, and the source does not report whether patients were immunized, how viral variants changed over time, or whether the analysis accounted for prior kidney disease and other potential confounders in detail. The findings therefore describe outcomes within this hospitalized Palestinian cohort and may not represent all COVID-19 patients, including those treated outside hospitals or in other health systems.

The results position acute kidney injury as an important complication of severe hospitalized COVID-19 rather than merely a laboratory abnormality. Severity markers and measures of systemic inflammation were closely linked to mortality, but the data do not determine whether inflammatory injury, critical illness, ventilation, kidney dysfunction, or their combination drove the observed risk. What the study does establish is a strong clinical association: among hospitalized adults with COVID-19, acute kidney injury was common, more severe stages accompanied worse outcomes, and the condition was linked to a 3.5-fold increase in the odds of death in the cohort’s multivariable analysis. The authors identified disease severity, intensive care management, and inflammatory load as principal determinants of outcome, providing a detailed account of renal complications in a setting for which regional data had been limited.

Subject of Research: Incidence, predictors, mortality, and renal recovery associated with acute kidney injury in hospitalized COVID-19 patients in Palestine

Article Title: Acute kidney injury in hospitalized COVID-19 patients: predictors, risk factors, mortality, and renal recovery from a bi-center cohort in Palestine

Article References: Abu-Helu, R., Albasha, D. J., Naseef, H. A., & Adwan, G. (2026). Acute kidney injury in hospitalized COVID-19 patients: predictors, risk factors, mortality, and renal recovery from a bi-center cohort in Palestine. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14391-3

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14391-3

Keywords: COVID-19, acute kidney injury, hospitalized patients, mortality, renal recovery, intensive care, Palestine, SARS-CoV-2, Acute, kidney, injury, hospitalized