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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.

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Authors+Show Affiliations

Yang X
Department of Critical Care Medicine, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China. jyy623@163.com.
Jin Y
College of Letters & Science, University of California, Berkeley, Berkeley, CA, 94720, USA.
Li R
Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.
Zhang Z
Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, People's Republic of China.
Sun R
Department of Critical Care Medicine, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China.
Chen D
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.

MeSH

Acute Kidney InjuryBetacoronavirusCOVID-19Coronavirus InfectionsHumansPandemicsPneumonia, ViralPrevalenceSARS-CoV-2

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_ DB - PRIME DP - Unbound Medicine ER -