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Prevalence and impact of acute renal impairment on COVID-19: a systematic review and meta-analysis.
Crit Care. 2020 06 18; 24(1):356.CC

Abstract

BACKGROUND

The aim of this study is to assess the prevalence of abnormal urine analysis and kidney dysfunction in COVID-19 patients and to determine the association of acute kidney injury (AKI) with the severity and prognosis of COVID-19 patients.

METHODS

The electronic database of Embase and PubMed were searched for relevant studies. A meta-analysis of eligible studies that reported the prevalence of abnormal urine analysis and kidney dysfunction in COVID-19 was performed. The incidences of AKI were compared between severe versus non-severe patients and survivors versus non-survivors.

RESULTS

A total of 24 studies involving 4963 confirmed COVID-19 patients were included. The proportions of patients with elevation of sCr and BUN levels were 9.6% (95% CI 5.7-13.5%) and 13.7% (95% CI 5.5-21.9%), respectively. Of all patients, 57.2% (95% CI 40.6-73.8%) had proteinuria, 38.8% (95% CI 26.3-51.3%) had proteinuria +, and 10.6% (95% CI 7.9-13.3%) had proteinuria ++ or +++. The overall incidence of AKI in all COVID-19 patients was 4.5% (95% CI 3.0-6.0%), while the incidence of AKI was 1.3% (95% CI 0.2-2.4%), 2.8% (95% CI 1.4-4.2%), and 36.4% (95% CI 14.6-58.3%) in mild or moderate cases, severe cases, and critical cases, respectively. Meanwhile, the incidence of AKI was 52.9%(95% CI 34.5-71.4%), 0.7% (95% CI - 0.3-1.8%) in non-survivors and survivors, respectively. Continuous renal replacement therapy (CRRT) was required in 5.6% (95% CI 2.6-8.6%) severe patients, 0.1% (95% CI - 0.1-0.2%) non-severe patients and 15.6% (95% CI 10.8-20.5%) non-survivors and 0.4% (95% CI - 0.2-1.0%) survivors, respectively.

CONCLUSION

The incidence of abnormal urine analysis and kidney dysfunction in COVID-19 was high and AKI is closely associated with the severity and prognosis of COVID-19 patients. Therefore, it is important to increase awareness of kidney dysfunction in COVID-19 patients.

Authors+Show Affiliations

Department of Critical Care Medicine, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China. jyy623@163.com.College of Letters & Science, University of California, Berkeley, Berkeley, CA, 94720, USA.Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, People's Republic of China.Department of Critical Care Medicine, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China.Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China. 18918520002@189.cn. Department of Critical Care Medicine, Ruijin North Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201800, People's Republic of China. 18918520002@189.cn.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

32552872

Citation

Yang, Xianghong, et al. "Prevalence and Impact of Acute Renal Impairment On COVID-19: a Systematic Review and Meta-analysis." Critical Care (London, England), vol. 24, no. 1, 2020, p. 356.
Yang X, Jin Y, Li R, et al. Prevalence and impact of acute renal impairment on COVID-19: a systematic review and meta-analysis. Crit Care. 2020;24(1):356.
Yang, X., Jin, Y., Li, R., Zhang, Z., Sun, R., & Chen, D. (2020). Prevalence and impact of acute renal impairment on COVID-19: a systematic review and meta-analysis. Critical Care (London, England), 24(1), 356. https://doi.org/10.1186/s13054-020-03065-4
Yang X, et al. Prevalence and Impact of Acute Renal Impairment On COVID-19: a Systematic Review and Meta-analysis. Crit Care. 2020 06 18;24(1):356. PubMed PMID: 32552872.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and impact of acute renal impairment on COVID-19: a systematic review and meta-analysis. AU - Yang,Xianghong, AU - Jin,Yiyang, AU - Li,Ranran, AU - Zhang,Zhongheng, AU - Sun,Renhua, AU - Chen,Dechang, Y1 - 2020/06/18/ PY - 2020/04/09/received PY - 2020/06/04/accepted PY - 2020/6/20/entrez PY - 2020/6/20/pubmed PY - 2020/7/4/medline KW - 2019-nCoV KW - Acute kidney injury KW - Continuous renal replacement therapy KW - Meta-analysis KW - Renal impairment KW - SARS-CoV-2 SP - 356 EP - 356 JF - Critical care (London, England) JO - Crit Care VL - 24 IS - 1 N2 - BACKGROUND: The aim of this study is to assess the prevalence of abnormal urine analysis and kidney dysfunction in COVID-19 patients and to determine the association of acute kidney injury (AKI) with the severity and prognosis of COVID-19 patients. METHODS: The electronic database of Embase and PubMed were searched for relevant studies. A meta-analysis of eligible studies that reported the prevalence of abnormal urine analysis and kidney dysfunction in COVID-19 was performed. The incidences of AKI were compared between severe versus non-severe patients and survivors versus non-survivors. RESULTS: A total of 24 studies involving 4963 confirmed COVID-19 patients were included. The proportions of patients with elevation of sCr and BUN levels were 9.6% (95% CI 5.7-13.5%) and 13.7% (95% CI 5.5-21.9%), respectively. Of all patients, 57.2% (95% CI 40.6-73.8%) had proteinuria, 38.8% (95% CI 26.3-51.3%) had proteinuria +, and 10.6% (95% CI 7.9-13.3%) had proteinuria ++ or +++. The overall incidence of AKI in all COVID-19 patients was 4.5% (95% CI 3.0-6.0%), while the incidence of AKI was 1.3% (95% CI 0.2-2.4%), 2.8% (95% CI 1.4-4.2%), and 36.4% (95% CI 14.6-58.3%) in mild or moderate cases, severe cases, and critical cases, respectively. Meanwhile, the incidence of AKI was 52.9%(95% CI 34.5-71.4%), 0.7% (95% CI - 0.3-1.8%) in non-survivors and survivors, respectively. Continuous renal replacement therapy (CRRT) was required in 5.6% (95% CI 2.6-8.6%) severe patients, 0.1% (95% CI - 0.1-0.2%) non-severe patients and 15.6% (95% CI 10.8-20.5%) non-survivors and 0.4% (95% CI - 0.2-1.0%) survivors, respectively. CONCLUSION: The incidence of abnormal urine analysis and kidney dysfunction in COVID-19 was high and AKI is closely associated with the severity and prognosis of COVID-19 patients. Therefore, it is important to increase awareness of kidney dysfunction in COVID-19 patients. SN - 1466-609X UR - https://www.unboundmedicine.com/medline/citation/32552872/Prevalence_and_impact_of_acute_renal_impairment_on_COVID_19:_a_systematic_review_and_meta_analysis_ L2 - https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-03065-4 DB - PRIME DP - Unbound Medicine ER -