The Association Between Chronic Kidney Disease and New Onset Renal Replacement Therapy on the Outcome of COVID-19 Patients: A Meta-analysis

Abstract

Objective: The aim of the study was to evaluate the association between chronic kidney disease (CKD) and new onset renal replacement therapy (RRT) with the outcome of Coronavirus Disease 2019 (COVID-19) in patients. Methodology: A systematic literature search from several databases was performed on studies that assessed CKD, use of RRT, and the outcome of COVID-19. The composite of poor outcome consisted of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care, and use of mechanical ventilator. Results: Nineteen studies with a total of 7216 patients were included. CKD was associated with increased composite poor outcome (RR 2.63 [1.33, 5.17], P = .03; I2 = 51%, P = .01) and its subgroup, consisting of mortality (RR 3.47 [1.36, 8.86], P = .009; I2 = 14%, P = .32) and severe COVID-19 (RR 2.89 [0.98, 8.46], P = .05; I2 = 57%, P = .04). RRT was associated with increased composite poor outcome (RR 18.04 [4.44, 73.25], P < .001; I2 = 87%, P < .001), including mortality (RR 26.02 [5.01, 135.13], P < .001; I2 = 60%, P = .06), severe COVID-19 (RR 12.95 [1.93, 86.82], P = .008; I2 = 81%, P < .001), intensive care (IC) (RR 14.22 [1.76, 114.62], P < .01; I2 = 0%, P < .98), and use of mechanical ventilator (RR 34.39 [4.63, 255.51], P < .0005). Conclusion: CKD and new-onset RRT were associated with poor outcome in patients with COVID-19.

Hypocalcemia is associated with severe COVID-19: A systematic review and meta-analysis

“…3 ]. Hypocalcemia was associated with sensitivity of 0.74 [0.53, 0.88], specificity of 0.54 [0.29, 0.77], PLR of 1.6 [1.1, 2.3], NLR of 0.49 [0.35, 0.66], DOR of 3 [ 2 , 5 ], and AUC of 0.70 [0.66, 0.74] [ Fig. 4 ].…”

“…Additionally, hypocalcemia in critically ill patients might be caused by other complications such as acute renal insufficiency, pancreatitis, and alkalosis; which may lead to poor prognosis [ 22 ]. Chronic renal and liver disease may also cause hypocalcemia and these were associated with poor prognosis in COVID-19 [ 24 ]. Vitamin D deficiency might also be found more frequently in the elderly patients and in those with less exposure due to reasons such as comorbidities and frailty, which themselves, are associated with mortality [ [25] , [26] , [27] ].…”

“…Clinical presentation in patients with coronavirus Disease-2019 (COVID-19) ranges from mild to critical, with multiple complications requiring ventilator support [ 1 , 2 ]. Patients with comorbidities are at higher risk of developing a more severe condition [ [3] , [4] , [5] , [6] , [7] ]. Simple and non-invasive assessments are helpful to identify patients at higher risk for severe outcome that requires more intensive monitoring and respiratory support.…”

Lethal Arrhythmia (Torsade de Pointes) in COVID-19: An Event Synergistically Induced by Viral Associated Cardiac Injury, Hyperinflammatory Response, and Treatment Drug?

“…We also encourage further studies to create a prognostic model that incorporates the presence of arrhythmia along with other established risk factors and comorbidities for prognostication in severe COVID-19. 35 - 40 …”

“…We also encourage further studies to create a prognostic model that incorporates the presence of arrhythmia along with other established risk factors and comorbidities for prognostication in severe COVID-19. [35][36][37][38][39][40] Since we began treating COVID-19, the majority of international, national, 41 and our hospital guidelines have recommended the administration of chloroquine or hydroxychloroquine for the initial treatment of COVID-19. However, the Center for Disease Control and Prevention (CDC) and the National Institute of Health (NIH) have recently updated the previous recommendation concerning the use of chloroquine or hydroxychloroquine due to unclear efficacy and potential cardiotoxic adverse effects.…”