Coronavirus-associated kidney outcomes in COVID-19, SARS, and MERS: a meta-analysis and systematic review.
Ren Fail
; 43(1): 1-15, 2020 Nov 09.
Article
in English
| MEDLINE | ID: covidwho-951457
ABSTRACT
OBJECTIVES:
A meta-analysis and systematic review was conducted on kidney-related outcomes of three recent pandemics SARS, MERS, and COVID-19, which were associated with potentially fatal acute respiratory distress syndrome (ARDS).METHODS:
A search of all published studies until 16 June 2020 was performed. The incidence/prevalence and mortality risk of acute and chronic renal events were evaluated, virus prevalence, and mortality in preexisting hemodialysis patients was investigated.RESULTS:
A total of 58 eligible studies involving 13452 hospitalized patients with three types of coronavirus infection were included. The reported incidence of new-onset acute kidney injury (AKI) was 12.5% (95% CI 7.6%-18.3%). AKI significantly increased the mortality risk (OR = 5.75, 95% CI 3.75-8.77, p < 0.00001) in patients with coronavirus infection. The overall rate of urgent-start kidney replacement therapy (urgent-start KRT) use was 8.9% (95% CI 5.0%-13.8%) and those who received urgent-start KRT had a higher risk of mortality (OR = 3.43, 95% CI 2.02-5.85, p < 0.00001). Patients with known chronic kidney disease (CKD) had a higher mortality than those without CKD (OR = 1.97, 95% CI 1.56-2.49, p < 0.00001). The incidence of coronavirus infection was 7.7% (95% CI 4.9%-11.1%) in prevalent hemodialysis patients with an overall mortality rate of 26.2% (95% CI 20.6%-32.6%).CONCLUSIONS:
Primary kidney involvement is common with coronavirus infection and is associated with significantly increased mortality. The recognition of AKI, CKD, and urgent-start KRT as major risk factors for mortality in coronavirus-infected patients are important steps in reducing future mortality and long-term morbidity in hospitalized patients with coronavirus infection.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Coronavirus Infections
/
Severe Acute Respiratory Syndrome
/
Acute Kidney Injury
/
COVID-19
/
Kidney Failure, Chronic
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Limits:
Humans
Language:
English
Journal:
Ren Fail
Journal subject:
Nephrology
Year:
2020
Document Type:
Article
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