Coronavirus-associated kidney outcomes in COVID-19, SARS, and MERS: a meta-analysis and systematic review

Zhou, Shoulian; Xu, Jing; Xue, Cheng; Yang, Bo; Mao, Zhiguo; Ong, Albert

doi:10.1080/0886022x.2020.1847724

Cited by 31 publications

(45 citation statements)

References 93 publications

(217 reference statements)

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“…Mean CRP and d dimer levels were 133.1 mg/dl and 2196 ng/ml, comparative to our results [13]. 35% of the patients in our study died, slightly higher than prior studies that showed mortality rates of 26-32% [14, 15].…”

Section: Discussioncontrasting

confidence: 62%

Outcomes of COVID-19 among Patients with End Stage Renal Disease on Remdesivir

Selvaraj

Baig

Dapaah-Afriyie

et al. 2021

Preprint

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BACKGROUND: Since the beginning of COVID-19 pandemic, there has been widespread use of remdesivir in adults and children. There is little known information about its outcomes in patients with severe renal dysfunction or end stage renal disease who are on hemodialysis. METHODS: A retrospective, multicenter study was conducted on patients with end stage renal disease on hemodialysis that were discharged after treatment for COVID-19 between April 1st and December 31st, 2020. Primary endpoints were length of stay, mortality, maximum oxygen requirements along with escalation of care needing mechanical ventilation. Secondary endpoints included change in C reactive protein, d dimer levels and disposition. RESULTS: A total of 52 charts were reviewed, of which 28 met the inclusion criteria. 14 patients received remdesivir, and 14 patients did not receive remdesivir. The majority of patients were caucasian, female, with diabetes mellitus and hypertension. Mean age was 65.33 +14.14 years. All the patients in the remdesivir group received dexamethasone as compared to only 30% of patients in the non-remdesivir group. There was no significant difference in C reactive protein, d dimer levels, and disposition between the two groups. Approximately 35% of the patients died, 18% required intensive ventilation and mean length of stay was 12.21 days. DISCUSSION: The study demonstrated no clinically significant difference in length of stay, maximum oxygen requirements or mortality in COVID-19 patients with end-stage renal disease in the remdesivir group as compared to the non-remdesivir group. Further studies are needed to study the effects of remdesivir on the renal function and disease course in patients with chronic kidney disease stage 4 or 5 that are not on dialysis.

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Section: Discussioncontrasting

confidence: 62%

Outcomes of COVID-19 among Patients with End Stage Renal Disease on Remdesivir

Selvaraj

Baig

Dapaah-Afriyie

et al. 2021

Preprint

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“…Some ESRD with HD patients might need to visit a hospital for in-center hemodialysis during COVID-19 epidemics and pandemics which might increase the risk of SARS-CoV-2 exposure both from transportation to hospital and visiting hospital [ 55 – 57 ]. A recent meta-analysis on pre-existing hemodialysis patients provided a similar concern with 8.0% COVID-19 incidence in HD patients [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

“…There was no difference in CFR among different RRT modalities which might relate to the lack of association of COVID-19 mortality and immunosuppression regimen [ 66 ], and surrogates in kidney transplant patients [ 67 ]. Subgroup analysis provided a 14.87% case fatality rate in HD patients which was lower than the 25.7% case fatality rate in HD patients from another meta-analysis [ 58 ]. The disparity might originate from different eligibility criteria and research objectives between the two studies.…”

Section: Discussionmentioning

confidence: 99%

Covid-19 in end-stage renal disease patients with renal replacement therapies: A systematic review and meta-analysis

et al. 2021

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Background The novel coronavirus (COVID-19), caused by SARS-CoV-2, showed various prevalence and case-fatality rates (CFR) among patients with different pre-existing chronic conditions. End-stage renal disease (ESRD) patients with renal replacement therapy (RRT) might have a higher prevalence and CFR due to reduced immune function from uremia and kidney tropism of SARS-CoV-2, but there was a lack of systematic study on the infection and mortality of the SARS-CoV-2 infection in ESRD patients with various RRT. Methodology/Principal findings We searched five electronic databases and performed a systematic review and meta-analysis up to June 30, 2020, to evaluate the prevalence and case fatality rate (CFR) of the COVID-19 infection among ESRD patients with RRT. The global COVID-19 data were retrieved from the international database on June 30, 2020, for estimating the prevalence and CFR of the general population as referencing points. Of 3,272 potential studies, 34 were eligible studies consisted of 1,944 COVID-19 confirmed cases in 21,873 ESRD patients with RRT from 12 countries in four WHO regions. The overall pooled prevalence in ESRD patients with RRT was 3.10% [95% confidence interval (CI) 1.25–5.72] which was higher than referencing 0.14% global average prevalence. The overall estimated CFR of COVID-19 in ESRD patients with RRT was 18.06% (95% CI 14.09–22.32) which was higher than the global average at 4.98%. Conclusions This meta-analysis suggested high COVID-19 prevalence and CFR in ESRD patients with RRT. ESRD patients with RRT should have their specific protocol of COVID-19 prevention and treatment to mitigate excess cases and deaths.

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“…Compared to patients with Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) in which the incidence of AKI is 6.7% and 42% respectively 11 , 12 . The incidence of AKI in COVID-19 patients is highly variable.…”

Section: Epidemiology Of Aki In Covid-19 Patientsmentioning

confidence: 99%

Inflammatory stress in SARS-COV-2 associated Acute Kidney Injury

Chen¹,

Wang²,

Tang³

et al. 2021

Int. J. Biol. Sci.

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Increasing clinical evidence shows that acute kidney injury (AKI) is a common and severe complication in critically ill COVID-19 patients. The older age, the severity of COVID-19 infection, the ethnicity, and the history of smoking, diabetes, hypertension, and cardiovascular disease are the risk factor for AKI in COVID-19 patients. Of them, inflammation may be a key player in the pathogenesis of AKI in patients with COVID-19. It is highly possible that SARS-COV-2 infection may trigger the activation of multiple inflammatory pathways including angiotensin II, cytokine storm such as interleukin-6 (IL-6), C-reactive protein (CRP), TGF-β signaling, complement activation, and lung-kidney crosstalk to cause AKI. Thus, treatments by targeting these inflammatory molecules and pathways with a monoclonal antibody against IL-6 (Tocilizumab), C3 inhibitor AMY-101, anti-C5 antibody, anti-TGF-β OT-101, and the use of CRRT in critically ill patients may represent as novel and specific therapies for AKI in COVID-19 patients.

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Coronavirus-associated kidney outcomes in COVID-19, SARS, and MERS: a meta-analysis and systematic review

Cited by 31 publications

References 93 publications

Outcomes of COVID-19 among Patients with End Stage Renal Disease on Remdesivir

Outcomes of COVID-19 among Patients with End Stage Renal Disease on Remdesivir

Covid-19 in end-stage renal disease patients with renal replacement therapies: A systematic review and meta-analysis

Inflammatory stress in SARS-COV-2 associated Acute Kidney Injury

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