Global REnal Involvement of CORonavirus Disease 2019 (RECORD): A Systematic Review and Meta-Analysis of Incidence, Risk Factors, and Clinical Outcomes
| Autor: | Sydney C.W. Tang, Pak Wing Lee, Kam Yan Yu, Kar Neng Lai, Kam Wa Chan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Medicine (General)
medicine.medical_specialty renal medicine medicine.medical_treatment 030232 urology & nephrology urologic and male genital diseases 03 medical and health sciences R5-920 0302 clinical medicine systematic review Internal medicine meta-regression medicine 030212 general & internal medicine Renal replacement therapy Risk factor business.industry Incidence (epidemiology) Acute kidney injury COVID-19 General Medicine Odds ratio medicine.disease Confidence interval female genital diseases and pregnancy complications meta-analysis internal medicine acute kidney injury risk factor Meta-analysis Medicine business Kidney disease |
| Zdroj: | Frontiers in Medicine Frontiers in Medicine, Vol 8 (2021) |
| ISSN: | 2296-858X |
| Popis: | Introduction: The quantitative effect of underlying non-communicable diseases on acute kidney injury (AKI) incidence and the factors affecting the odds of death among coronavirus disease 2019 (COVID-19) AKI patients were unclear at population level. This study aimed to assess the association between AKI, mortality, underlying non-communicable diseases, and clinical risk factors.Methods: A systematic search of six databases was performed from January 1, 2020, until October 5, 2020. Peer-reviewed observational studies containing quantitative data on risk factors and incidence of renal manifestations of COVID-19 were included. Location, institution, and time period were matched to avoid duplicated data source. Incidence, prevalence, and odds ratio of outcomes were extracted and pooled by random-effects meta-analysis. History of renal replacement therapy (RRT) and age group were stratified for analysis. Univariable meta-regression models were built using AKI incidence as dependent variable, with underlying comorbidities and clinical presentations at admission as independent variables.Results: Global incidence rates of AKI and RRT in COVID-19 patients were 20.40% [95% confidence interval (CI) = 12.07–28.74] and 2.97% (95% CI = 1.91–4.04), respectively, among patients without RRT history. Patients who developed AKI during hospitalization were associated with 8 times (pooled OR = 9.03, 95% CI = 5.45–14.94) and 16.6 times (pooled OR = 17.58, 95% CI = 10.51–29.38) increased odds of death or being critical. At population level, each percentage increase in the underlying prevalence of diabetes, hypertension, chronic kidney disease, and tumor history was associated with 0.82% (95% CI = 0.40–1.24), 0.48% (95% CI = 0.18–0.78), 0.99% (95% CI = 0.18–1.79), and 2.85% (95% CI = 0.93–4.76) increased incidence of AKI across different settings, respectively. Although patients who had a kidney transplant presented with a higher incidence of AKI and RRT, their odds of mortality was lower. A positive trend of increased odds of death among AKI patients against the interval between symptom onset and hospital admission was observed.Conclusion: Underlying prevalence of non-communicable diseases partly explained the heterogeneity in the AKI incidence at population level. Delay in admission after symptom onset could be associated with higher mortality among patients who developed AKI and warrants further research. |
| Databáze: | OpenAIRE |
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