Pulmonary Involvement Severity on CT Scan and Its Correlation with Acute Kidney Injury in Hospitalized COVID-19 Patients: A Single-Institution Study

Abstract

Background: The severity of lung involvement in COVID-19 patients, as assessed by computed tomography (CT), is associated with disease outcomes. While the pulmonary manifestations of the virus are well-known, less is understood about its impact on other organs, particularly the kidneys. Objectives: This study investigates the correlation between lung involvement and acute kidney injury (AKI) in COVID-19 patients. Methods: A retrospective study of 50 COVID-19 patients admitted to Afzalipour Hospital, Kerman, Iran, from April to September 2020 was conducted. Non-contrast chest CT scans were evaluated using the total severity score (TSS) to quantify lung involvement. Patients were monitored for AKI, defined by changes in serum creatinine (SCr) and urine output. Statistical analyses, including Spearman’s correlation and logistic regression, were performed using SPSS version 26 to assess the relationship between lung involvement and AKI. Results: The mean age of the 50 participants (46% male) was 46.88 ± 16.23 years. A one-unit increase in TSS was associated with a 5.099-fold increased risk of AKI (P = 0.031). A strong positive correlation was found between the severity of lung involvement and SCr levels (r = 0.959, P < 0.0001). Additionally, a one-unit increase in lung involvement raised the odds of reduced urine output by 14.04 times (P = 0.026). A significant negative correlation (r = -0.432, P = 0.022) was observed between lung severity and glomerular filtration rate (GFR). No significant correlation was found between lung involvement and electrolyte levels. Conclusions: The severity of lung involvement on CT is strongly correlated with the development of AKI in COVID-19 patients. These findings highlight the need for vigilant renal function monitoring in patients with high TSS, as severe lung damage can predispose individuals to systemic organ dysfunction, including AKI.