Prevalence and Outcomes in COVID-19 patients with AKI: A meta-analysis

PurposeThe coronavirus strain first reported in December 2019 (COVID-19) has spread rapidly worldwide, posing a seriously risk to human health. However, the relationship between acute kidney injury (AKI) and the COVID-19 infection is limited. There is ongoing controversy about AKI in COVID-19, some studies have argued the presence of AKI as being very common and a characteristic side-effect of the virus, while others pointed that AKI remains a rare incident among COVID-19 infections. This meta-analysis aims to shed much-needed light on the relationship between COVID-19 and AKI, and provide a stronger evidence base to support both further research and clinical application. MethodsTwo authors independently performed a literature search using PubMed, Web of Science, Embase, and Cochrane Library. Literature published up until May 04, 2020 (inclusive). Then the incidence of AKI, incidence of RRT required, the mortality rate with AKI and the risk of death with AKI during a COVID-19 infection were statistically analyzed using Open Meta-Analyst software, from which conclusions are derived. ResultsWe found that the incidence of AKI in hospitalized patients with the COVID-19 infection remains low, only about 3.8%; the in-hospital mortality rate with AKI in COVID-19 infected patients reaches up to 86.8%; the odds of death with AKI in COVID-19 infected patients is about 24.2 times higher than those without AKI. ConclusionsThe occurrence of AKI during a COVID-19 infection should be paid greater attention, and should be considered a strong red flag with regards to the patients risk of death. Additional studies are still required to support the conclusions derived herein and to explore the AKI mechanism during a COVID-19 infection. Take-home messageThis meta-analysis was based on the inclusion of 5,448 in-hospital COVID-19 infected patients, and first time indicated that although the incidence of AKI observed during a COVID-19 infection is lower, but it is a strong signal of patient deterioration, to critical illness and even death.