Characteristics of COVID-19 Patients who Developed Acute Kidney Injury and Its Association with Mortality: A Systematic Review

ABSTRACT

Introduction: AKI incidence reported in COVID-19 patients is increasing with contradictory study results about AKI development with increased mortality. This study was conducted to assess a possible correlation between risk factors that led to AKI and increased mortality. Methods: A total of eight articles found through an online database published between 2020 and 2021 were used. A total of 9 455 patients with COVID-19 were divided into AKI and non-AKI. Results: There are 2 754 AKI patients with a mean age of 67, 1 781 (64.7 %) are male, 1 161 (42.1 %) are diabetic, 1 823 (66.2 %) hypertensive, and 1 508 (54.7 %) use mechanical ventilation, with 39.2 % (1 052) mortality rate. In non-AKI patients, there are 6 701 patients with a mean age of 60, 3 595 (53.6 %) are male, 1 759 (26.2 %) are diabetic, 3 133 (46.7 %) hypertensive, and 490 (7.3 %) use mechanical ventilation, with a 7.6 % (508) mortality rate. Several studies suggest various mechanisms of AKI development, including multi-organ dysfunction syndrome, direct kidney infection, acute respiratory distress syndrome, infection-related mitochondrial failure, cytokine storm, SARS-CoV-2 renal tropism, and even mechanical ventilation usage. Conclusion: AKI contributes to and or correlates with severity, prognosis, and mortality in COVID-19 patients. It develops more often in older males with Diabetes and or Hypertension and those with mechanical ventilation compared to non-AKI patients. Mortality in COVID-19 with AKI population is significantly higher than in those without AKI. © 2023 Academia Nacional de Medicina. All rights reserved.