AKI during COVID-19 infection: low incidence, high risk of death

Abstract

Purpose:The coronavirus strain first reported in December 2019 has spread rapidly worldwide, posing a seriously risk to human health. However, the relationship between acute kidney injury (AKI) and the COVID-19 infection is limited.There is ongoing controversy about AKI in COVID-19, some studies have argued the presence of AKI as being very common and a characteristic side-effect of the virus, while others pointed that AKI remains a rare incident among COVID-19 infections.This meta-analysis aims to shed much-needed light on the relationship between COVID-19 and AKI, and provide a stronger evidence base to support both further research and clinical application. Methods:Two authors independently performed a literature search using PubMed, Web of Science, Embase, and Cochrane Library. Literature published up until May 04, 2020 (inclusive). Then the incidence of AKI, incidence of RRT required, the mortality rate with AKI and the risk of death with AKI during a COVID-19 infection were statistically analyzed using Open Meta-Analyst software, from which conclusions are derived. Results:We found that the incidence of AKI in hospitalized patients with the COVID-19 infection remains low, only about 3.8%; the in-hospital mortality rate with AKI in COVID-19 infected patients reaches up to 86.8%; the odds of death with AKI in COVID-19 infected patients is about 24.2 times higher than those without AKI. Conclusions:The occurrence of AKI during a COVID-19 infection should be paid greater attention, and should be considered a strong red flag with regards to the patient's risk of death. Additional studies are still required to support the conclusions derived herein and to explore the AKI mechanism during a COVID-19 infection.

Acute kidney injury and mortality in coronavirus disease 2019: results from a cohort study of 1,280 patients

“…However, the sum of the incidences of stage 2 and stage 3 was 9%. According to previous studies, the incidence of AKI varies widely from 0.5% to 29% [1,2,17,18]. The well-known risk factors for AKI are underlying diseases such as diabetes mellitus, systemic arterial hypertension, elderly age, and/or chronic kidney disease [19].…”

Pharmacotherapy for Patients with Chronic Kidney Disease during the COVID-19: A Narrative Review

“…Severe COVID-19 prompts AKI in 20% to 40% of severe cases, and it is associated with a higher risk of mortality [13,14,15]. A meta-analysis investigated the possible association between renal dysfunction including AKI and clinical manifestations (including severity and mortality) of COVID-19 cases; the authors reported that the high proportion of AKI in non-survival patients was 31% [16].…”

Pharmacotherapeutic Evaluation of Covid-19 Patients Suffering from Acute Kidney Injury

“…In clinical investigations of COVID-19, AKI is presented as an independent predisposing cause of mortality [13]. Studies have shown that critically ill AKI patients infected with coronavirus are at increased risk of mortality ranging from 8% to 23% [14,15]. Some studies even showed an in-hospital mortality rate of 62%, 77%, and 80% among COVID-19 patients with Stage I, Stage II, and Stage III AKI, respectively [16].…”