{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T18:52:57Z","timestamp":1763664777295,"version":"3.45.0"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ARC CoE Engineered Quantum Systems","award":["A14PAN"],"award-info":[{"award-number":["A14PAN"]}]},{"DOI":"10.13039\/501100020171","name":"Foreign, Commonwealth and Development Office","doi-asserted-by":"publisher","award":["215091\/Z\/18\/Z,222410\/Z\/21\/Z, 225288\/Z\/22\/Z and 220757\/Z\/20\/Z"],"award-info":[{"award-number":["215091\/Z\/18\/Z,222410\/Z\/21\/Z, 225288\/Z\/22\/Z and 220757\/Z\/20\/Z"]}],"id":[{"id":"10.13039\/501100020171","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1209135"],"award-info":[{"award-number":["OPP1209135"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute Kidney Injury (AKI) is common among COVID-19 patients and is associated with a higher risk of death. Compared to earlier COVID-19 variants, Omicron has reduced mortality. To study the relationship between Omicron and AKI, we conducted the first international study using the global International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 global dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational study aims to characterise AKI in a cohort of 3,908 COVID-19 patients admitted to the intensive care unit (ICU) across six countries. Clinical characteristics were compared between Omicron and pre-Omicron patients. Multivariable logistic regression was used to analyse the relationship between the Omicron variant and AKI. AKI was defined based on the change in serum creatinine levels, in accordance with the Kidney Disease Improving Global Outcome AKI guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients admitted to an ICU during the Omicron wave were older and had more comorbidities than pre-Omicron patients. The prevalence of AKI was the same between Omicron and previous variants (24.7% vs 22.9%, p-value\u2009=\u20090.321). Controlling for confounders, ICU patients with the Omicron variant were 30%\u221240% less likely to develop AKI compared to patients with previous variants. The survival curves between AKI patients with Omicron and non-Omicron variants were consistent with the survival analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After adjusting for demographics, comorbidities, laboratory findings, and treatments, patients in ICU during the Omicron wave were less likely to develop AKI compared to previous eras. Nevertheless, the precise influence of the Omicron variant on kidney function remains a subject of ongoing discussion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0336843","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T18:39:17Z","timestamp":1763663957000},"page":"e0336843","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Omicron surge impact on acute kidney injury in ICU patients: A study using the ISARIC COVID-19 database"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3984-291X","authenticated-orcid":true,"given":"Danyang","family":"Dai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3520-3225","authenticated-orcid":true,"given":"Pedro Franca","family":"Gois","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5915-6101","authenticated-orcid":true,"given":"Marina","family":"Wainstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moji","family":"Ghadimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8417-0212","authenticated-orcid":true,"given":"Nicholas","family":"Spyrison","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolando Claure-Del","family":"Granado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Shrapnel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0413-5434","authenticated-orcid":true,"given":"Jason D.","family":"Pole","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"ISARIC Characterization Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"pone.0336843.ref001","unstructured":"Organization WH. WHO Coronavirus (COVID-19) Dashboard. https:\/\/covid19.who.int"},{"key":"pone.0336843.ref002","author":"WHO","year":"2021"},{"key":"pone.0336843.ref003","volume-title":"1.1.529): SARS-CoV-2 Variant of Concern","author":"Classification of Omicron (B","year":"2022"},{"key":"pone.0336843.ref004","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.80556","article-title":"An international observational study to assess the impact of the Omicron variant emergence on the clinical epidemiology of COVID-19 in hospitalised patients","volume":"11","author":"BP Gon\u00e7alves","year":"2022","journal-title":"Elife"},{"issue":"10323","key":"pone.0336843.ref005","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/S0140-6736(22)00017-4","article-title":"Early assessment of the clinical severity of the SARS-CoV-2 omicron variant in South Africa: a data linkage study","volume":"399","author":"N Wolter","year":"2022","journal-title":"Lancet"},{"issue":"9","key":"pone.0336843.ref006","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1038\/s41591-022-01887-z","article-title":"Clinical outcomes associated with SARS-CoV-2 Omicron (B.1.1.529) variant and BA.1\/BA.1.1 or BA.2 subvariant infection in Southern California","volume":"28","author":"JA Lewnard","year":"2022","journal-title":"Nature Medicine"},{"issue":"10332","key":"pone.0336843.ref007","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/S0140-6736(22)00462-7","article-title":"Comparative analysis of the risks of hospitalisation and death associated with SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study","volume":"399","author":"T Nyberg","year":"2022","journal-title":"Lancet"},{"issue":"4","key":"pone.0336843.ref008","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003969","article-title":"Use of an extended KDIGO definition to diagnose acute kidney injury in patients with COVID-19: A multinational study using the ISARIC-WHO clinical characterisation protocol","volume":"19","author":"M Wainstein","year":"2022","journal-title":"PLoS Med"},{"key":"pone.0336843.ref009","article-title":"Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19","author":"M Wainstein","year":"2023","journal-title":"Kidney Int Rep"},{"issue":"2","key":"pone.0336843.ref010","article-title":"Outcomes Among Patients Hospitalized With COVID-19 and Acute Kidney Injury","volume":"77","author":"JH Ng","year":"2021","journal-title":"Am J Kidney Dis"},{"issue":"5","key":"pone.0336843.ref011","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.kint.2020.03.005","article-title":"Kidney disease is associated with in-hospital death of patients with COVID-19","volume":"97","author":"Y Cheng","year":"2020","journal-title":"Kidney Int"},{"issue":"3","key":"pone.0336843.ref012","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1159\/000514940","article-title":"Incidence and Outcomes of Acute Kidney Injury in COVID-19: A Systematic Review","volume":"51","author":"R Raina","year":"2022","journal-title":"Blood Purif"},{"issue":"2","key":"pone.0336843.ref013","doi-asserted-by":"crossref","first-page":"2263583","DOI":"10.1080\/0886022X.2023.2263583","article-title":"Factors associated with acute kidney injury (AKI) and mortality in COVID-19 patients in a Sub-Saharan African intensive care unit: a single-center prospective study","volume":"45","author":"Y Nlandu","year":"2023","journal-title":"Ren Fail"},{"key":"pone.0336843.ref014","article-title":"ISARIC COVID-19 Clinical Data Report: Final Report January 2020 \u2013 January 2023","author":"ICC Group","year":"2023","journal-title":"medRxiv"},{"issue":"1","key":"pone.0336843.ref015","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1038\/s41597-022-01534-9","article-title":"ISARIC-COVID-19 dataset: A Prospective, Standardized, Global Dataset of Patients Hospitalized with COVID-19","volume":"9","author":"Group ISARIC Clinical Characterization","year":"2022","journal-title":"Sci Data"},{"key":"pone.0336843.ref016","article-title":"Features of 20\u2009133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study","volume":"369","author":"AB Docherty","year":"2020","journal-title":"BMJ"},{"key":"pone.0336843.ref017","unstructured":"ISARIC. Clinical characterisation protocol (CCP). https:\/\/isaric.org\/research\/covid-19-clinical-research-resources\/clinical-characterisation-protocol-ccp\/. 2023 October 1."},{"issue":"4","key":"pone.0336843.ref018","doi-asserted-by":"crossref","DOI":"10.1159\/000339789","article-title":"KDIGO clinical practice guidelines for acute kidney injury","volume":"120","author":"A Khwaja","year":"2012","journal-title":"Nephron Clin Pract"},{"issue":"6","key":"pone.0336843.ref019","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.2215\/CJN.07920713","article-title":"Epidemiology and outcomes in community-acquired versus hospital-acquired AKI","volume":"9","author":"A Wonnacott","year":"2014","journal-title":"Clin J Am Soc Nephrol"},{"key":"pone.0336843.ref020","volume-title":"R: A Language and Environment for Statistical Computing","author":"Team RC R","year":"2018"},{"issue":"43","key":"pone.0336843.ref021","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.21105\/joss.01686","article-title":"Welcome to the Tidyverse","volume":"4","author":"H Wickham","year":"2019","journal-title":"JOSS"},{"issue":"12","key":"pone.0336843.ref022","first-page":"700","article-title":"Interpreting estimates of treatment effects: implications for managed care","volume":"33","author":"SV Faraone","year":"2008","journal-title":"P T"},{"issue":"282","key":"pone.0336843.ref023","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1080\/01621459.1958.10501452","article-title":"Nonparametric Estimation from Incomplete Observations","volume":"53","author":"EL Kaplan","year":"1958","journal-title":"Journal of the American Statistical Association"},{"issue":"4","key":"pone.0336843.ref024","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1198\/000313006X152207","article-title":"On The So-Called \u201cHuber Sandwich Estimator\u201d and \u201cRobust Standard Errors\u201d","volume":"60","author":"DA Freedman","year":"2006","journal-title":"The American Statistician"},{"issue":"7","key":"pone.0336843.ref025","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002861","article-title":"A simple real-time model for predicting acute kidney injury in hospitalized patients in the US: A descriptive modeling study","volume":"16","author":"M Simonov","year":"2019","journal-title":"PLoS Med"},{"issue":"1","key":"pone.0336843.ref026","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1002\/mpr.329","article-title":"Multiple imputation by chained equations: what is it and how does it work?","volume":"20","author":"MJ Azur","year":"2011","journal-title":"Int J Methods Psychiatr Res"},{"issue":"1","key":"pone.0336843.ref027","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1002\/nur.10015","article-title":"Multiple imputation for missing data","volume":"25","author":"PA Patrician","year":"2002","journal-title":"Res Nurs Health"},{"issue":"9","key":"pone.0336843.ref028","doi-asserted-by":"crossref","first-page":"103372","DOI":"10.1016\/j.sjbs.2022.103372","article-title":"A comprehensive review on Covid-19 Omicron (B.1.1.529) variant","volume":"29","author":"R Manjunath","year":"2022","journal-title":"Saudi J Biol Sci"},{"issue":"7","key":"pone.0336843.ref029","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1016\/S1473-3099(22)00154-2","article-title":"Risk of hospitalisation associated with infection with SARS-CoV-2 omicron variant versus delta variant in Denmark: an observational cohort study","volume":"22","author":"P Bager","year":"2022","journal-title":"Lancet Infect Dis"},{"issue":"7","key":"pone.0336843.ref030","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.cmi.2023.03.017","article-title":"Clinical outcomes of the severe acute respiratory syndrome coronavirus 2 Omicron and Delta variant: systematic review and meta-analysis of 33 studies covering 6 037 144 coronavirus disease 2019-positive patients","volume":"29","author":"FH Hu","year":"2023","journal-title":"Clin Microbiol Infect"},{"issue":"3","key":"pone.0336843.ref031","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1093\/infdis\/jiac411","article-title":"Alpha to Omicron: Disease Severity and Clinical Outcomes of Major SARS-CoV-2 Variants","volume":"227","author":"FP Esper","year":"2023","journal-title":"J Infect Dis"},{"issue":"3","key":"pone.0336843.ref032","doi-asserted-by":"crossref","first-page":"492","DOI":"10.3390\/idr14030052","article-title":"COVID-19 Variants in Critically Ill Patients: A Comparison of the Delta and Omicron Variant Profiles","volume":"14","author":"A Corriero","year":"2022","journal-title":"Infect Dis Rep"},{"key":"pone.0336843.ref033","article-title":"Comparison of clinical characteristics between SARS-CoV-2 Omicron variant and Delta variant infections in China","volume":"9","author":"Q Li","year":"2022","journal-title":"Frontiers in Medicine"},{"issue":"6","key":"pone.0336843.ref034","doi-asserted-by":"crossref","first-page":"831","DOI":"10.7326\/M22-0308","article-title":"Comparison of patients infected with delta versus omicron COVID-19 variants presenting to Paris emergency departments: a retrospective cohort study","volume":"175","author":"D Bouzid","year":"2022","journal-title":"Ann Intern Med"},{"issue":"5","key":"pone.0336843.ref035","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1177\/10815589221140592","article-title":"Validation of a predictive model for hospital-acquired acute kidney injury with emergence of SARS-CoV-2 variants","volume":"71","author":"MC McAdams","year":"2023","journal-title":"J Investig Med"},{"issue":"2","key":"pone.0336843.ref036","doi-asserted-by":"crossref","DOI":"10.1016\/S2665-9913(21)00001-1","article-title":"Too long to wait: the impact of COVID-19 on elective surgery","volume":"3","author":"Rheumatology The Lancet","year":"2021","journal-title":"Lancet Rheumatol"},{"issue":"10","key":"pone.0336843.ref037","first-page":"2072","article-title":"UK Healthcare Workers\u2019 Experiences of Major System Change in Elective Surgery During the COVID-19 Pandemic: Reflections on Rapid Service Adaptation","volume":"11","author":"G Singleton","year":"2022","journal-title":"Int J Health Policy Manag"},{"key":"pone.0336843.ref038","doi-asserted-by":"crossref","unstructured":"Coronavirus pandemic (COVID-19). https:\/\/ourworldindata.org\/coronavirus. 2020. 2023 September 7.","DOI":"10.4324\/9781003095590-2"},{"issue":"4","key":"pone.0336843.ref039","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003969","article-title":"Use of an extended KDIGO definition to diagnose acute kidney injury in patients with COVID-19: A multinational study using the ISARIC-WHO clinical characterisation protocol","volume":"19","author":"M Wainstein","year":"2022","journal-title":"PLoS Med"},{"key":"pone.0336843.ref040","unstructured":"WHO. EG.5 Initial Risk Evaluation, 9 August 2023. https:\/\/www.who.int\/activities\/tracking-SARS-CoV-2-variants; 2023."}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0336843","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T18:39:30Z","timestamp":1763663970000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0336843"}},"subtitle":[],"editor":[{"given":"Vipa","family":"Thanachartwet","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,11,20]]},"references-count":40,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,20]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0336843","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,20]]}}}