National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
PLoS One. 2020 Nov 16;15(11):e0241953. doi: 10.1371/journal.pone.0241953. eCollection 2020.
The novel coronavirus is pandemic around the world. Several researchers have given the evidence of impacts of COVID-19 on the respiratory, cardiovascular and gastrointestinal system. Studies still have debated on kidney injury of COVID-19 patients. The purpose of the meta-analysis was to evaluate the association of kidney impairment with the development of COVID-19.
The PubMed, Embase and MedRxiv databases were searched until May 1, 2020. We extracted data from eligible studies to summarize the clinical manifestations and laboratory indexes of kidney injury on COVID-19 infection patients and further compared the prevalence of acute kidney injury (AKI) and the mean differences of three biomarkers between in ICU/severe and non-ICU/non-severe cases. Heterogeneity was evaluated using the I2 method.
In the sum of 24 studies with 10180 patients were included in this analysis. The pooled prevalence of AKI, increased serum creatinine (Scr), increased blood urea nitrogen (BUN), increased D-dimer, proteinuria and hematuria in patients with COVID-19 were 16.2%, 8.3%, 6.2%, 49.8%, 50.1% and 30.3% respectively. Moreover, the means of Scr, BUN and D-dimer were shown 6.4-folds, 1.8-folds and 0.67-folds, respectively, higher in ICU/severe cases than in corresponding non-ICU/non-severe patients. The prevalence of AKI was about 30 folds higher in ICU/severe patients compared with the non-ICU/non-severe cases.
Overall, we assessed the incidences of the clinic and laboratory features of kidney injury in COVID-19 patients. And kidney dysfunction may be a risk factor for COVID-19 patients developing into the severe condition. In reverse, COVID-19 can also cause damage to the kidney.
新型冠状病毒在全球范围内流行。一些研究人员已经提供了 COVID-19 对呼吸系统、心血管系统和胃肠道系统影响的证据。关于 COVID-19 患者的肾脏损伤，研究仍存在争议。本荟萃分析的目的是评估肾脏损伤与 COVID-19 发展之间的关系。
检索了 PubMed、Embase 和 MedRxiv 数据库，截至 2020 年 5 月 1 日。我们从合格研究中提取数据，以总结 COVID-19 感染患者肾脏损伤的临床表现和实验室指标，并进一步比较 ICU/重症病例和非 ICU/非重症病例中急性肾损伤（AKI）的患病率和三个生物标志物的平均值差异。使用 I² 方法评估异质性。
共纳入 24 项研究，共 10180 例患者。AKI、血清肌酐（Scr）升高、血尿素氮（BUN）升高、D-二聚体升高、蛋白尿和血尿在 COVID-19 患者中的总体患病率分别为 16.2%、8.3%、6.2%、49.8%、50.1%和 30.3%。此外，Scr、BUN 和 D-二聚体的平均值分别升高 6.4 倍、1.8 倍和 0.67 倍，ICU/重症病例高于相应的非 ICU/非重症病例。与非 ICU/非重症病例相比，ICU/重症病例的 AKI 患病率约高 30 倍。
总的来说，我们评估了 COVID-19 患者肾脏损伤的临床和实验室特征发生率。肾功能障碍可能是 COVID-19 患者发展为重症的危险因素。相反，COVID-19 也可能导致肾脏损伤。
