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?:abstract
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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
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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
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