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Cardiorenal Syndrome in COVID-19 Patients: A Systematic Review
Ling Lin1, Yangqin Chen1, Dongwan Han1
1Department of Infectious Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Insights
Cardiorenal syndrome, involving both heart and kidney issues, significantly worsens outcomes for patients with COVID-19. Early detection and management of these complications are crucial for improving survival rates in coronavirus disease patients.
Area of Science:
- Cardiology
- Nephrology
- Infectious Diseases
Background:
- The 2019 coronavirus disease (COVID-19) pandemic has highlighted numerous systemic complications.
- Cardiorenal syndrome, characterized by concurrent cardiac and renal dysfunction, is increasingly recognized in COVID-19 patients.
Approach:
- A systematic review was conducted to assess clinical manifestations and outcomes of cardiorenal syndrome in COVID-19.
- Relevant studies were retrieved from PubMed, MEDLINE, and EMBASE (December 2019–February 2022).
Key Points:
- Fifteen studies involving 637 patients identified cardiorenal syndrome or combined cardiac/renal complications in COVID-19.
- Common cardiac issues included myocardial injury, heart failure, and arrhythmias; renal complications primarily involved acute kidney injury.
- Elevated inflammatory markers (CRP, PCT, IL-6) were frequently observed in patients with cardiorenal injury.
Conclusions:
- Cardiorenal syndrome and concurrent cardiac/renal complications are associated with more severe COVID-19 disease.
- These cardiorenal complications significantly impact disease severity and increase mortality rates in COVID-19 patients.
Aims:
To perform a systematic review assessing the clinical manifestations and outcomes of cardiorenal syndrome or the presence of both cardiac and renal complications in the 2019 coronavirus disease (COVID-19) patients.
Methods:
All relevant studies about cardiorenal syndrome or both cardiac and renal complications in COVID-19 patients were retrieved on PUBMED, MEDLINE, and EMBASE from December 1, 2019 to February 20, 2022.
Results:
Our search identified 15 studies including 637 patients with a diagnosis of cardiorenal syndrome or evidence of both cardiac and renal complications followingSARS-CoV-2 infection. They were male predominant (66.2%, 422/637), with a mean age of 58 years old. Cardiac complications included myocardial injury (13 studies), heart failure (7 studies), arrhythmias (5 studies), or myocarditis and cardiomyopathy (2 studies). Renal complications manifested as acute kidney injury with or without oliguria. Patients with cardiorenal injury were often associated with significantly elevated levels of inflammatory markers (CRP, PCT, IL-6). Patients with a diagnosis of cardiorenal syndrome or evidence of both cardiac and renal complications had more severe disease and poorer prognosis (9 studies).
Conclusion:
The presence of either cardiorenal syndrome or concurrent cardiac and renal complications had a significant impact on the severity of the disease and the mortality rate among patients with COVID-19 infection. Therefore, careful assessment and management of potential cardiac and renal complications in patients with COVID-19 infection are important to improve their outcomes.
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