tetano
Editor, Senior Moderator
Clin Exp Med
. 2021 Apr 23.
doi: 10.1007/s10238-021-00715-x. Online ahead of print.
Kidney disease and COVID-19 disease severity-systematic review and meta-analysis
Jagmeet Singh[SUP] 1 [/SUP], Preeti Malik[SUP] 2 [/SUP], Nidhi Patel[SUP] 3 [/SUP], Suveenkrishna Pothuru[SUP] 4 [/SUP], Avantika Israni[SUP] 5 [/SUP], Raja Chandra Chakinala[SUP] 6 [/SUP], Maryam Rafaqat Hussain[SUP] 7 [/SUP], Anusha Chidharla[SUP] 8 [/SUP], Harshil Patel[SUP] 9 [/SUP], Saurabh Kumar Patel[SUP] 10 [/SUP], Rizwan Rabbani[SUP] 11 [/SUP], Urvish Patel[SUP] 7 [/SUP], Savneek Chugh[SUP] 12 [/SUP], Asim Kichloo[SUP] 13 [/SUP]
Affiliations
Abstract
We aimed to identify prevalence and association of comorbid chronic kidney disease (CKD), acute kidney injury (AKI) and utilization prevalence of continuous renal replacement therapy (CRRT) in COVID-19-hospitalized patients as a function of severity status. With the ongoing struggle across the globe to combat COVID-19 disease, published literature has described the role of kidney disease in COVID-19 patients based on single/multicenter experiences across the globe. We extracted data from observational studies describing comorbid CKD, AKI and CRRT and outcomes and severity of COVID-19-hospitalized patients from December 1, 2019-August 20, 2020 following PRISMA guidelines. Severity of COVID-19 includes intensive care unit admission, oxygen saturation < 90%, invasive mechanical ventilation utilization, in-hospital admission and mortality. Meta-analysis was performed using a random-effects model to calculate pooled estimates, and forest plots were created. In total, 29 studies with 15,017 confirmed COVID-19 patients were included. The overall prevalence of AKI was 11.6% [(430/3693)], comorbid CKD 9.7% [(1342/13,728)] and CRRT 2.58% [(102/3946)] in our meta-analysis. We also found higher odds of comorbid CKD (pooled OR: 1.70; 95%CI: 1.21-2.40; p = 0.002), AKI (8.28; 4.42-15.52; p < 0.00001) and utilization of CRRT (16.90; 9.00-31.74; p < 0.00001) in patients with severe COVID-19 disease. Conclusion Our meta-analysis suggests that comorbid CKD, AKI and utilization of CRRT were significantly associated with COVID-19 disease severity. Clinicians should focus on early triaging of COVID-19 patients with comorbid CKD and at risk for AKI to prevent complication and mortality.
Keywords: COVID-19; Chronic kidney disease; Continuous renal replacement therapy; Coronavirus; Kidney disease; Kidney injury.
. 2021 Apr 23.
doi: 10.1007/s10238-021-00715-x. Online ahead of print.
Kidney disease and COVID-19 disease severity-systematic review and meta-analysis
Jagmeet Singh[SUP] 1 [/SUP], Preeti Malik[SUP] 2 [/SUP], Nidhi Patel[SUP] 3 [/SUP], Suveenkrishna Pothuru[SUP] 4 [/SUP], Avantika Israni[SUP] 5 [/SUP], Raja Chandra Chakinala[SUP] 6 [/SUP], Maryam Rafaqat Hussain[SUP] 7 [/SUP], Anusha Chidharla[SUP] 8 [/SUP], Harshil Patel[SUP] 9 [/SUP], Saurabh Kumar Patel[SUP] 10 [/SUP], Rizwan Rabbani[SUP] 11 [/SUP], Urvish Patel[SUP] 7 [/SUP], Savneek Chugh[SUP] 12 [/SUP], Asim Kichloo[SUP] 13 [/SUP]
Affiliations
- PMID: 33891214
- DOI: 10.1007/s10238-021-00715-x
Abstract
We aimed to identify prevalence and association of comorbid chronic kidney disease (CKD), acute kidney injury (AKI) and utilization prevalence of continuous renal replacement therapy (CRRT) in COVID-19-hospitalized patients as a function of severity status. With the ongoing struggle across the globe to combat COVID-19 disease, published literature has described the role of kidney disease in COVID-19 patients based on single/multicenter experiences across the globe. We extracted data from observational studies describing comorbid CKD, AKI and CRRT and outcomes and severity of COVID-19-hospitalized patients from December 1, 2019-August 20, 2020 following PRISMA guidelines. Severity of COVID-19 includes intensive care unit admission, oxygen saturation < 90%, invasive mechanical ventilation utilization, in-hospital admission and mortality. Meta-analysis was performed using a random-effects model to calculate pooled estimates, and forest plots were created. In total, 29 studies with 15,017 confirmed COVID-19 patients were included. The overall prevalence of AKI was 11.6% [(430/3693)], comorbid CKD 9.7% [(1342/13,728)] and CRRT 2.58% [(102/3946)] in our meta-analysis. We also found higher odds of comorbid CKD (pooled OR: 1.70; 95%CI: 1.21-2.40; p = 0.002), AKI (8.28; 4.42-15.52; p < 0.00001) and utilization of CRRT (16.90; 9.00-31.74; p < 0.00001) in patients with severe COVID-19 disease. Conclusion Our meta-analysis suggests that comorbid CKD, AKI and utilization of CRRT were significantly associated with COVID-19 disease severity. Clinicians should focus on early triaging of COVID-19 patients with comorbid CKD and at risk for AKI to prevent complication and mortality.
Keywords: COVID-19; Chronic kidney disease; Continuous renal replacement therapy; Coronavirus; Kidney disease; Kidney injury.