tetano
Editor, Senior Moderator
Ren Fail
. 2020 Nov 9;43(1):1-15.
doi: 10.1080/0886022X.2020.1847724.
Coronavirus-associated kidney outcomes in COVID-19, SARS, and MERS: a meta-analysis and systematic review
Shoulian Zhou[SUP] 1 [/SUP], Jing Xu[SUP] 1 [/SUP], Cheng Xue[SUP] 1 [/SUP], Bo Yang[SUP] 2 [/SUP], Zhiguo Mao[SUP] 1 [/SUP], Albert C M Ong[SUP] 3 4 [/SUP]
Affiliations
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: COVID-19; MERS; SARS; kidney; outcome.
. 2020 Nov 9;43(1):1-15.
doi: 10.1080/0886022X.2020.1847724.
Coronavirus-associated kidney outcomes in COVID-19, SARS, and MERS: a meta-analysis and systematic review
Shoulian Zhou[SUP] 1 [/SUP], Jing Xu[SUP] 1 [/SUP], Cheng Xue[SUP] 1 [/SUP], Bo Yang[SUP] 2 [/SUP], Zhiguo Mao[SUP] 1 [/SUP], Albert C M Ong[SUP] 3 4 [/SUP]
Affiliations
- PMID: 33256491
- DOI: 10.1080/0886022X.2020.1847724
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: COVID-19; MERS; SARS; kidney; outcome.