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Coronavirus-associated kidney outcomes in COVID-19, SARS, and MERS: a meta-analysis and systematic review

Shoulian Zhou1, Jing Xu1, Cheng Xue1

  • 1Division of Nephrology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China.

Renal Failure
|December 1, 2020
PubMed

Insights

Kidney injury is common in coronavirus infections like SARS, MERS, and COVID-19, significantly increasing mortality risk. Recognizing acute kidney injury (AKI) and chronic kidney disease (CKD) is crucial for better patient outcomes.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • Recent pandemics (SARS, MERS, COVID-19) caused severe respiratory distress syndrome (ARDS).
  • Kidney-related complications were noted but required systematic evaluation across these viral outbreaks.

Purpose of the Study:

  • To conduct a meta-analysis and systematic review of kidney outcomes in SARS, MERS, and COVID-19.
  • To evaluate the incidence, prevalence, and mortality risk of acute and chronic kidney events.
  • To investigate virus prevalence and mortality in hemodialysis patients.

Main Methods:

  • Systematic search of published studies up to June 16, 2020.
  • Meta-analysis of kidney-related outcomes in hospitalized patients with coronavirus infections.
  • Evaluation of acute kidney injury (AKI), chronic kidney disease (CKD), and kidney replacement therapy (KRT) use and outcomes.

Main Results:

  • Included 58 studies with 13,452 patients.
  • New-onset AKI occurred in 12.5% and significantly increased mortality risk (OR=5.75).
  • Urgent-start KRT (8.9%) and pre-existing CKD were associated with higher mortality.
  • Hemodialysis patients had a 7.7% infection rate and 26.2% mortality.

Conclusions:

  • Primary kidney involvement is frequent in coronavirus infections.
  • AKI, CKD, and urgent-start KRT are major mortality risk factors.
  • Recognizing these kidney issues is vital for reducing mortality and long-term morbidity.
Abstract

Keywords:
COVID-19MERSSARSkidneyoutcome

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