Contrast-induced nephropathy in Covid 19 patients undergoing emergency percutaneous coronary intervention

Abstract

Background: Covid 19 is an infectious disease, which leads to many adverse effects, such as hypercoagulopathy. Since, the number of the emergency percutaneous coronary intervention (PCI) has increased due to this effect during the pandemic, hence the incidence of contrast induced nephropathy(CIN) has rised.The present study aimed to investigate the risk of developing CIN and the risk factors that may cause CIN in COVID-19 patients, who underwent emergency percutaneous coronary intervention (PCI). Materials and methods: A total of 69 patients, who was diagnosed with COVID -19 and underwent emergency PCI were included in the study. CIN was defined as an increase in serum creatinine value above 0.3 mg/dL within 48 hours after coronary angiography. The patients were allocated to the two groups as developing and not developing CIN, respectively. Results: CIN was developed in 25 (36.2%) patients. Diabetes mellitus was detected in 42% (29) of the patients. Diabetes mellitus and lower ejection fractions (EF) were more observed in patients who developed CIN. (for DM p=0.002, for lower EF p-value =0.034). Furthermore, CRP, ferritin and D-dimer levels were higher in patients who developed CIN (p values respectively; p=0.024, p=0.032, p= 0.021) (Table-1) There was no significant difference between the groups with and without CIN in terms of gender, age, albumin, troponin I and hemoglobin values. Additionally, pre-angiography creatinine value was higher and eGFR levels were lower in the CIN group (p values respectively; p=0.028, p=0.015). Conclusion: In the present study, we demonstrated that in COVID -19 patients, who developed CIN had a greater burden of inflammation, greater incidence of DM and also lower ejection fraction. This study should be supported by prospective randomized studies for developing special treatment strategies for COVID-19 patient groups, who need emergency PCI.