Acute kidney injury is associated with severe infection and fatality in patients with COVID-19: A systematic review and meta-analysis of 40 studies and 24,527 patients.
Pharmacol Res
; 161: 105107, 2020 11.
Article
in English
| MEDLINE | ID: covidwho-1318943
ABSTRACT
Currently, coronavirus disease 2019 (COVID-19) is spreading rapidly around the world. This study aimed to investigate whether the presence of acute kidney injury (AKI) might increase the risk of severe infection and fatality in COVID-19 patients. We searched the PubMed, Web of Science, ScienceDirect, MedRxiv and COVID-19 academic research communication platforms for studies reporting severe infection rates and case-fatality rates in COVID-19 patients with and without AKI up to June 20, 2020. The main outcomes were the comparisons of the severe infection rates and fatality rates in COVID-19 patients with and without AKI and the estimation of the odds ratio (OR) and its 95 % confidence interval (CI) for severe infection and mortality. Statistical analyses were performed with R statistical software. A total of 40 studies involving 24,527 patients with COVID-19 were included in our meta-analysis. The incidence of AKI was 10 % (95 % CI 8%-13 %) in COVID-19 patients. The patients had higher severe infection and fatality rates (55.6 % vs. 17.7 % and 63.1 % vs. 12.9 %, respectively, all P < 0.01) with COVID-19. AKI was a predictor of fatality (OR = 14.63, 95 % CI 9.94-21.51, P < 0.00001) and severe infection (OR = 8.11, 95 % CI 5.01-13.13, P < 0.00001) in patients with COVID-19. Higher levels of serum creatinine (Scr) and blood urea nitrogen (BUN) were associated with a significant increase in fatality [Scr mean difference (MD) 20.19 µmol/L, 95 % CI 14.96-25.42, P < 0.001; BUN MD 4.07 mmol/L, 95 % CI 3.33-4.81, P < 0.001] and severe infection (Scr MD 7.78 µmol/L, 95 % CI 4.43-11.14, P < 0.00001, BUN MD 2.12 mmol/L, 95 % CI 1.74-2.50, P < 0.00001) in COVID-19 patients. In conclusion, AKI is associated with severe infection and higher fatality rates in patients with COVID-19. Clinicians should pay more attention to the monitoring and treatment of COVID-19 patients with AKI.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Acute Kidney Injury
/
COVID-19
Type of study:
Observational study
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Pharmacol Res
Journal subject:
Pharmacology
Year:
2020
Document Type:
Article
Affiliation country:
J.phrs.2020.105107
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