Objective: This is a prospective cohort of Covid -19 adult patients with AKI admitted in Indus Hospital COVID ICU from March 2020 to September 2020. History, clinical examination, laboratory investigations, and ultrasound imaging of the kidneys was acquired from the Health Management Information System (HMIS) record of the patients. The data was analyzed in SPSS version 21. Association between outcomes of AKI with different variables was assessed by applying Chi square test. P value of less than 0.05 was considered significant. Methods: There were total 208 patients with AKI in our study, in which 146 (70.2%) were male while 62(29.8%) were female. The mean age was 60.3± 12.7 years and the most prevalent comorbid was HTN 147(70.7%) in our patients, while the most common cause of AKI was sepsis 188(90.4%) and on the same way, oliguria was the most common symptoms of AKI 76(36.5%). Death was the most frequent outcome of our patients 147(70.7%) as compared to recovery 47(22.6%). There was male predominance in patients, who died with AKI as compared to female 112(76.2%) and 35(23.8%) respectively. Also treatment didn’t show any benefit on worst outcome. Similarly 124(59.6%) patients needed ventilatory support in which 118(95.2%) died while only 5 (4%) recovered (p <0.001) Results: Renal involvement in SARS-COV-2 infection is more common than initially thought and has been associated with increased morbidity and mortality. We have found significant association of AKI in covid-19 with outcome variables. Conclusions: Objective: There is continuous experience that AKI is very common in COVID-19 patients and that SARS-CoV-2 specifically invades the kidneys with poor outcome. To date no data has been found from Pakistan on outcome of AKI with Covid -19 infection. Therefore this study was conducted to help determine the outcome and associated risk factors in this part of the world. Methods: This is a prospective cohort of Covid -19 adult patients with AKI admitted in Indus Hospital COVID ICU from March 2020 to September 2020. History, clinical examination, laboratory investigations, and ultrasound imaging of the kidneys was acquired from the Health Management Information System (HMIS) record of the patients. The data was analyzed in SPSS version 21. Association between outcomes of AKI with different variables was assessed by applying Chi square test. P value of less than 0.05 was considered significant. Results: There were total 208 patients with AKI in our study, in which 146 (70.2%) were male while 62(29.8%) were female. The mean age was 60.3± 12.7 years and the most prevalent comorbid was HTN 147(70.7%) in our patients, while the most common cause of AKI was sepsis 188(90.4%) and on the same way, oliguria was the most common symptoms of AKI 76(36.5%). Death was the most frequent outcome of our patients 147(70.7%) as compared to recovery 47(22.6%). There was male predominance in patients, who died with AKI as compared to female 112(76.2%) and 35(23.8%) respectively. Also treatment didn’t show any benefit on worst outcome. Similarly 124(59.6%) patients needed ventilatory support in which 118(95.2%) died while only 5 (4%) recovered (p <0.001) Conclusions: Renal involvement in SARS-COV-2 infection is more common than initially thought and has been associated with increased morbidity and mortality. We have found significant association of AKI in covid-19 with outcome variables.