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COVID-19 outbreak and the impact on renal disorders: A rapid review
Behzad Lotfi1, Mohsen Mohammadrahimi2, Sakineh Hajebrahimi1
1Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
Coronavirus disease 2019 (COVID-19) significantly impacts kidney function and increases mortality risk in patients with kidney diseases. Acute kidney injury (AKI) in COVID-19 patients is associated with very high mortality rates, necessitating further research.
Area of Science:
- Nephrology
- Infectious Diseases
- Critical Care Medicine
Background:
- The coronavirus disease 2019 (COVID-19) pandemic has raised concerns about its impact on various organ systems.
- Patients with pre-existing kidney diseases may be particularly vulnerable to severe outcomes from COVID-19.
Purpose of the Study:
- To evaluate the effects of COVID-19 on renal function and mortality in patients with kidney diseases.
- To synthesize current evidence on the association between COVID-19 and kidney complications.
Main Methods:
- A rapid review methodology was employed, searching multiple databases including MEDLINE, Scopus, and Web of Science.
- Included studies underwent screening of titles, abstracts, and full texts, with 10 articles selected for qualitative synthesis.
- A meta-analysis was performed on binary data from 5 eligible studies comprising 964 COVID-19 positive patients.
Main Results:
- The cumulative incidence of acute kidney injury (AKI) among COVID-19 patients was 7.1% (95% CI: 1.8%-24.5%).
- Qualitative synthesis indicated a higher risk of in-hospital mortality for patients with COVID-19 and kidney diseases.
- The occurrence of AKI in the context of COVID-19 was linked to a very high mortality rate.
Conclusions:
- COVID-19 poses a significant threat to patients with kidney diseases, increasing their risk of AKI and in-hospital mortality.
- Further extensive research is crucial to fully understand the extent and mechanisms of renal involvement in COVID-19.
- Early recognition and management of kidney complications in COVID-19 patients are critical.
Abstract:
In this rapid review, we aimed to evaluate the effect of coronavirus disease 2019 (COVID-19) on renal functions and mortality of patients with kidney diseases. We searched MEDLINE, The Cochrane Library, Scopus, Embase, Web of Science, UpToDate, and TRIP databases using the following keywords: COVID-19, COVID19, 2019-nCoV, 2019-CoV, coronavirus, SARS-nCoV-2, urology, cancer, bladder, prostate, kidney, trauma, stone, neurogenic, and reconstructive. The initial search resulted in 495 records. After the primary screening of titles, abstracts, and full texts and removing duplicates, 10 articles were selected and included in this rapid review. Moreover, we performed meta-analysis of binary data for the outcomes with sufficient data. Owing to a high level of heterogeneity because of different study designs and contexts, we used a random model for the meta-analysis. Only 5 studies were eligible for the meta-analysis. In these studies, comprising 964 COVID-19 positive patients, the cumulative event rate of acute kidney injury (AKI) was 7.1% (95% confidence interval: 1.8%-24.5%, p<0.001, I2=92.4). Based on the qualitative synthesis of the 10 included studies, patients with COVID-19 and kidney diseases had higher risk of in-hospital mortality. If AKI occurs because of the novel coronavirus, the mortality rate will be very high. Therefore, we need further investigations and more studies to recognize the extent and the cause of renal involvement in COVID-19.
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