Bezerra et al. conducted a multicenter retrospective cohort study to determine clinical characteristics and risk factors for death among patients who developed acute kidney infection (AKI) due to COVID-19 infection in a Brazilian city. AKI was defined using the kidney disease improving global outcomes (KDIGO) scale. 424 patients were included, with a mean age of 66.42 years. In-hospital mortality was 90.1%, with no significant difference between the hospitals. Mechanical ventilation (MV) was required for 90.3% of patients and 76.7% used vasopressors. Requiring MV was the most important risk factor related to mortality. 79% of AKI patients were on dialysis, and 39% of these patients died within the first 24 hours of the first dialysis session. 4.7% were in KDIGO stage 1, 18.6% in stage 2, and 76.6% in stage 3. Patients in stage 3 required more mechanical ventilation compared to those in stage 1 (93.5% vs 80%), vasopressors (80.9% vs 70%), had sepsis associated AKI (91.1% vs 47.4%), and death (93.2% vs 80%). Requiring MV (OR = 8.44) and vasopressors (OR = 2.93) were significantly associated with mortality. The authors believe that local factors, such as limited hospital resources and the regional density of COVID, may have contributed to the high mortality rate.