Hypophosphatemia is an independent risk factor for AKI among hospitalized patients with COVID-19 infection

Chen, Zijin; Gao, Chenni; Yu, Haijin; Lin, Li; Liu, Jialin; Chen, Wei; Xiang, Xiaogang; Hussain, Hafiz Muhammad Jafar; Lee, Benjamin J.; Li, Chuanlei; Wei, Wenjie; Huang, Yuhan; Li, Xiang; Fang, Zhengying; Yu, Shuwen; Weng, Qinjie; Ouyang, Yan; Hu, Xiaofan; Tao, Jun; Liu, Jian; Lin, Li; Li, Mingyu; Xu, Xiao; Liú, Dan; Song, Yuchen; Lv, Xifeng; Zha, Yixin; Ye, Zhiyin; Jiang, Tingting; Jia, Jieshuang; Chen, Xiaonong; Bi, Yufang; Xue, Jun; Chen, Nan; Hu, Weiguo; He, Cijiang; Wang, Huiming; Liu, Jun; Xie, Jingyuan

doi:10.1080/0886022x.2021.1979039

Cited by 15 publications

(26 citation statements)

References 45 publications

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“…Chen et al reported that hypophosphatemia is an independent risk factor for acute kidney injury (AKI). They also indicated that renal tubular dysfunction might be the cause of renal phosphate loss [26].…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…They postulated that this finding might be explained by severe malnutrition in ESRD patients with COVID-19 [28]. Other suggested mechanisms associated hypophosphatemia with renal dysfunction [26]. AKI may follow the course of COVID-19 through several mechanisms [13].…”

Section: Discussionmentioning

confidence: 99%

“…The study by Chen et al had the largest study population with 823 subjects and the smallest sample of 32 subjects in the study by Xue et al [26,27]. Four studies compared the serum phosphate mean between study groups [25,[27][28][29], and three studies reported the outcomes of COVID-19 and laboratory findings between patients with or without hypophosphatemia [26,30,31]. The studies by Chen et [26,30,31].…”

Section: Studymentioning

confidence: 99%

“…Four studies compared the serum phosphate mean between study groups [25,[27][28][29], and three studies reported the outcomes of COVID-19 and laboratory findings between patients with or without hypophosphatemia [26,30,31]. The studies by Chen et [26,30,31]. The summary of the risk of bias assessment of the recruited studies is shown in the supplementary appendix (Table S1 and S2).…”

Section: Studymentioning

confidence: 99%

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Hypophosphatemia in Coronavirus Disease 2019 (COVID-19), Complications, and Considerations: A Systematic Review

Fakhrolmobasheri

Vakhshoori

Heidarpour

et al. 2022

BioMed Research International

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Coronavirus disease 2019 (COVID-19) has various manifestations on different body organs, including the lungs, heart, kidneys, and central nervous system. However, the frequency of electrolyte abnormalities, especially hypophosphatemia, is still debated in this pandemic. Our main aim in this review is to evaluate the frequency and complications of hypophosphatemia in COVID-19-infected individuals. A systematic literature review was performed in Web of Science, Scopus, PubMed, EMBASE, and Cochrane electronic databases with the combination of different keywords till October 2021. We recruited all relevant published records (including cross-sectional and case-control studies as well as editorials and brief reports) assessing hypophosphatemia among patients with COVID-19 infection. After assessing all 928 recruited records and discarding duplicates, 4 records met the inclusion criteria. Three articles were further included during a manual search of the literature. Overall, the included studies reported 1757 subjects (males: 51.3%), with the mean age ranging from 37.2 ± 13.6 years to 65.9 ± 13.9 years. Hypophosphatemia prevalence has been reported from 7.6% to 19.5%. Patients with the severe status of COVID-19 had a higher prevalence of low serum phosphate levels than those with moderate infection. This review indicates that hypophosphatemia might be categorized as a complication in clinical settings during the COVID-19 pandemic, requiring a high clinical suspicion to implement appropriate diagnostic and therapeutic interventions to prevent life-threatening outcomes. However, it needs to be more elucidated by further studies whether hypophosphatemia in severe COVID-19 is directly related to COVID-19 or is just a complication of severe illness.

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Section: Synthesis Of Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Studymentioning

confidence: 99%

Section: Studymentioning

confidence: 99%

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Hypophosphatemia in Coronavirus Disease 2019 (COVID-19), Complications, and Considerations: A Systematic Review

Fakhrolmobasheri

Vakhshoori

Heidarpour

et al. 2022

BioMed Research International

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“…Chen et al. found that in hospitalized COVID-19 patients, a higher level of serum phosphorus was associated with an increased risk of AKI [ 46 ]. Further research on the molecular biology mechanism is helpful in exploring the potential relationship between COVID-19 infection and AKI.…”

Section: Discussionmentioning

confidence: 99%

Hydroxychloroquine/chloroquine and the risk of acute kidney injury in COVID-19 patients: a systematic review and meta-analysis

Liao

Zhang

Liu³

2022

Renal Failure

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Objectives Hydroxychloroquine/chloroquine has been widely used as part of the standard treatment for patients with coronavirus disease 2019 (COVID-19). We conducted a systematic review and meta-analysis to determine whether hydroxychloroquine/chloroquine increases the risk of acute kidney injury (AKI) in COVID-19 patients. Methods PubMed and Embase were searched for related publications from inception to Dec 31, 2021, including randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) comparing the risk of AKI and/or increased creatinine in COVID-19 patients receiving hydroxychloroquine/chloroquine and other controls (active treatment and placebo). We conducted separate meta-analyses for RCTs and NRSIs based on fixed-effect model, with odds ratios (ORs) being considered as effect sizes. Results We included 21 studies in the analysis, with 12 were RCTs. Based on the RCTs, compared to placebo, the OR was 1.19 (95% confidence interval [CI]: 0.86, 1.64; p = .30, n = 4, moderate quality) for AKI and 1.00 (95%CI: 0.64, 1.56; p = .99, n = 5, moderate quality) for increased creatinine for patients received hydroxychloroquine/chloroquine treatment; compared to active treatment, the odds was 1.28 (95%CI: 0.65, 2.53; p = .47, n = 2, low quality) for AKI and 0.64 (95%CI: 0.13, 3.20; p = .59, n = 1, low quality) for increased creatine. Evidence from NRSIs showed slightly increased odds of AKI, with low quality. Conclusion Based on current available studies which were graded as low to moderate quality, there is insufficient evidence to conclude that hydroxychloroquine/chloroquine use is associated with increased risk of AKI or raised creatinine. Abbreviations: AKI: acute kidney injury; COVID-19: Coronavirus Disease 2019; RCT: randomized controlled trials; NRSI: non-randomized studies of interventions; OR: odds ratios; ROBIS-I: Risk Of Bias In Non-randomized Studies – of Interventions

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Risk factors, clinical characteristics and prognostic value of acute kidney injury in COVID-19 compared with influenza virus and respiratory syncytial virus

et al. 2023

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Background Acute Kidney Injury (AKI) complicates a substantial part of patients with COVID-19. Direct viral penetration of renal cells through the Angiotensin Converting Enzyme 2 receptor, and indirect damage by the aberrant inflammatory response characteristic of COVID-19 are likely mechanisms. Nevertheless, other common respiratory viruses such as Influenza and Respiratory Syncytial Virus (RSV) are also associated with AKI. Methods We retrospectively compared the incidence, risk factors and outcomes of AKI among patients who were admitted to a tertiary hospital because of infection with COVID-19, influenza (A + B) or RSV. Results We collected data of 2593 patients hospitalized with COVID-19, 2041 patients with influenza and 429 with RSV. Patients affected by RSV were older, had more comorbidities and presented with higher rates of AKI at admission and within 7 days (11.7% vs. 13.3% vs. 18% for COVID-19, influenza and RSV, respectively p = 0.001). Nevertheless, patients hospitalized with COVID-19 had higher mortality (18% with COVID-19 vs. 8.6% and 13.5% for influenza and RSV, respectively P < 0.001) and higher need of mechanical ventilation (12.4% vs. 6.5% vs.8.2% for COVID-19, influenza and RSV, respectively, P = 0.002). High ferritin levels and low oxygen saturation were independent risk factors for severe AKI only in the COVID-19 group. AKI in the first 48 h of admission and in the first 7 days of hospitalization were strong independent risk factors for adverse outcome in all groups. Conclusion Despite many reports of direct kidney injury by SARS-COV-2, AKI was less in patients with COVID-19 compared to influenza and RSV patients. AKI was a prognostic marker for adverse outcome across all viruses. Graphical abstract Supplementary Information The online version contains supplementary material available at 10.1007/s40620-023-01591-2.

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Hypophosphatemia is an independent risk factor for AKI among hospitalized patients with COVID-19 infection

Cited by 15 publications

References 45 publications

Hypophosphatemia in Coronavirus Disease 2019 (COVID-19), Complications, and Considerations: A Systematic Review

Hypophosphatemia in Coronavirus Disease 2019 (COVID-19), Complications, and Considerations: A Systematic Review

Hydroxychloroquine/chloroquine and the risk of acute kidney injury in COVID-19 patients: a systematic review and meta-analysis

Risk factors, clinical characteristics and prognostic value of acute kidney injury in COVID-19 compared with influenza virus and respiratory syncytial virus

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