Acute kidney injury in covid-19 is associated with mortality: A meta-analysis

Abstract

Background: By March 2020, The World Health Organization (WHO) has declared Coronavirus disease-19 (COVID-19) as a global pandemic. Further investigations found that COVID-19 may lead to acute kidney injury (AKI). Some studies have been done, but the incidence and outcome of AKI in COVID-19 are variable between studies. Moreover, given the high number of COVID-19 cases in our country, we aimed to perform a systematic review and meta-analysis regarding the detailed outcome of AKI in COVID-19 patients as reported in the available literature. Methods: We performed a comprehensive literature search from several databases, such as EuropePMC, PubMed, ProQuest, Directory of Open Access Journal (DOAJ), and related references between December 1, 2019, and December 5, 2020. The primary outcome was mortality, and the secondary outcomes were the need for Intensive Care Unit (ICU) care, severe and critical COVID-19 infection, and Acute Respiratory Distress Syndrome (ARDS). Results: There were a total of 25,990 patients from 21 studies. Acute kidney injury was associated with increased odds of mortality (OR 13.43 [8.35, 21.60], p < 0.00001; I2: 82%, p < 0.00001), need for ICU care (OR 14.57 [8.51, 24.94], p < 0.00001; I²: 84%; p < 0.0001), critical COVID-19 (OR 10.41 [3.88, 27.90], p < 0.00001; I²: 67%; p = 0.02), and ARDS (OR 2.84 [1.30, 6.22], p = 0.009; I²: 91%; p = 0.001). Conclusion: Acute kidney injury is associated with mortality, need for ICU care, critical COVID-19 patients, and ARDS.