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COVID-19 and AcuteKidney Injury: ASystematic Review andMeta-Analysis Fabrizio FabriziCarlo AlfieriRoberta Cerutti2020 год

COVID-19 and Acute Kidney Injury: A Systematic Review and Meta-Analysis
review

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Аннотация: Background: coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome—coronavirus-2 (SARS-CoV-2)—is an ongoing pandemic with high morbidity and mortality rates. Preliminary evidence suggests that acute kidney injury (AKI) is uncommon in patients with COVID-19 and associated with poor outcomes. Study aims and design: we performed a systematic review of the literature with a meta-analysis of clinical studies to evaluate the frequency of AKI and dialysis requirement in patients who underwent hospitalization due to COVID-19. The incidence of AKI according to the death risk was calculated in these patients. The random-effects model of DerSimonian and Laird was adopted, with heterogeneity and stratified analyses. Results: thirty-nine clinical studies (n = 25,566 unique patients) were retrieved. The pooled incidence of AKI was 0.154 (95% CI, 0.107; 0.201; p < 0.0001) across the studies. Significant heterogeneity was found (p = 0.0001). The overall frequency of COVID-19-positive patients who underwent renal replacement therapy (RRT) was 0.043 (95% CI, 0.031; 0.055; p < 0.0001); no publication bias was found (Egger’s test, p = 0.11). The pooled estimate of AKI incidence in patients with severe COVID-19 was 0.53 (95% CI, 0.427; 0.633) and heterogeneity occurred (Q = 621.08, I2 = 97.26, p = 0.0001). According to our meta-regression, age (p < 0.007) and arterial hypertension (p < 0.001) were associated with AKI occurrence in hospitalized COVID-19 positive patients. The odds ratio (OR) for the incidence of AKI in deceased COVID-19 positive patients was greater than among survivors, 15.4 (95% CI, 20.99; 11.4; p < 0.001). Conclusions: AKI is a common complication in hospitalized COVID-19 positive patients. Additional studies are under way to assess the risk of AKI in COVID-19 patients and to deepen the mechanisms of kidney injury.
Год издания: 2020
Авторы: Fabrizio Fabrizi, Carlo Alfieri, Roberta Cerutti, G. Lunghi, Piergiorgio Messa
Издательство: Multidisciplinary Digital Publishing Institute
Источник: Pathogens
Ключевые слова: COVID-19 Clinical Research Studies, COVID-19 and healthcare impacts, Long-Term Effects of COVID-19
Другие ссылки: Pathogens (PDF)
Pathogens (HTML)
DOAJ (DOAJ: Directory of Open Access Journals) (HTML)
Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (PDF)
Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (HTML)
PubMed Central (HTML)
PubMed (HTML)