Research Article Procalcitonin and High APACHE (Acute Physiological and Chronic Health Evaluation) Level Are Associated with the Course of Acute Kidney Injury in Patients with SARS-CoV-2 Jorge Andrade Sierra , 1,2,3 Claudia Delgado Astorga , 1 Miriam Gabriela Nava Vargas , 1 EnriqueRojasCampos , 3 KevinJavierArrelanoArteaga , 1 KarlaHern´ andez Morales , 1 Carlos A. Andrade Castellanos , 1 Antonio de Jes ´ us Andrade-Ortega , 2 and Luis Gerardo Gonz´ alez Correa 3 1 Department of Internal Medicine, Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, Jalisco, Mexico 2 Department of Physiology, University Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico 3 Medical Research Unit in Kidney Diseases, Specialties Hospital, National Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico Correspondence should be addressed to Jorge Andrade Sierra; jorg_andrade@hotmail.com Received 27 April 2022; Revised 12 September 2022; Accepted 23 September 2022; Published 7 October 2022 Academic Editor: Tun-Chieh Chen Copyright © 2022 Jorge Andrade Sierra et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Acute kidney injury (AKI) is associated with poor outcomes in patients infected with SARS-CoV-2. Sepsis, direct injury to kidney cells by the virus, and severe systemic inflammation are mechanisms implicated in its development. We in- vestigated the association between inflammatory markers (C-reactive protein, procalcitonin, D-dimer, lactate dehydrogenase, and ferritin) in patients infected with SARS-CoV-2 and the development of AKI. Methods. A prospective cohort study performed at the Civil Hospital (Dr. Juan I. Menchaca) Guadalajara, Mexico, included patients aged >18 years with a diagnosis of SARS-CoV-2 pneumonia confirmed by RT-PCR and who did or did not present with AKI (KDIGO) while hospitalized. Biomarkers of in- flammation were recorded, and kidney function was estimated using the CKD-EPI formula. Results. 291 patients were included (68% males; average age, 57 years). e incidence of AKI was 40.5% (118 patients); 21% developed stage 1 AKI, 6% developed stage 2 AKI, and 14% developed stage 3 AKI. e development of AKI was associated with higher phosphate (p � 0.002) (RR 1.39, CI 95% 1.13–1.72), high procalcitonin levels at hospital admission (p � 0.005) (RR 2.09, CI 95% 1.26–3.50), and high APACHE scores (p � 0.011) (RR 2.0, CI 95% 1.17–3.40). e survival analysis free of AKI according to procalcitonin levels and APACHE scores demonstrated a lower survival in patients with procalcitonin >0.5 ng/ml (p � 0.001) and APACHE >15 points (p � 0.004). Conclusions. Phosphate, high procalcitonin levels, and APACHE levels >15 were predictors of AKI development in patients hospitalized with COVID-19. 1. Introduction e coronavirus disease 2019 (COVID-19) pandemic, which originated with the novel coronavirus (SARS-CoV-2), caused 318 thousand deaths in Mexico as of February 2022 [1]. Older adults with comorbidities [2, 3] are at a higher risk of com- plications from SARS-CoV-2 infections. Kidney damage is one of the main complications and can be demonstrated by the presence of hematuria, proteinuria [4–6], and the development of acute kidney injury (AKI), with a high inci- dence reported in hospitalized patients. [7–10] e severity leads to even higher mortality, which has a multifactorial etiology [11, 12]. Nevertheless, baseline characteristics, patient interventions in critical care, and organ crosstalk are mech- anisms that influence the appearance of AKI, but possible direct injury by the virus on kidney cells (podocytes, proximal tubule cells, and the epithelial cells of Bowman’s capsule) [13–15] and uncontrolled systemic inflammation are factors Hindawi International Journal of Clinical Practice Volume 2022, Article ID 1363994, 9 pages https://doi.org/10.1155/2022/1363994