Zhou Yangzhong, Ren Qidong, Chen Gang, Jin Qiao, Cui Quexuan, Luo Huiting, Zheng Ke, Qin Yan, Li Xuemei
Department of Nephrology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
School of Medicine, Tsinghua University, Beijing, China.
Front Med (Lausanne). 2020 Nov 3;7:588301. doi: 10.3389/fmed.2020.588301. eCollection 2020.
Renal involvement has been implicated in coronavirus disease 2019 (COVID-19), but the related prevalence and prognosis were largely unknown. In this meta-analysis, we searched the literature from PubMed, Embase, through bioRxiv, and medRxiv until April 26, 2020. Studies reporting chronic kidney diseases (CKDs) and/or acute kidney injury (AKI) were included. Demographics, relevant data of disease severity, and patient's prognosis were extracted and aggregated. Twenty-one thousand one hundred sixty-four patients from 52 peer-reviewed studies were included. Thirty-seven studies ( = 16,922) reported CKD in COVID-19 patients at diagnosis, and the pooled prevalence was 3.52% (95% CI, 1.98-5.48%; = 93%). Subgroup analysis showed that CKD prevalence was higher in severe cases [odds ratio (OR), 3.42; 95% CI 2.05-5.61; = 0%] compared to those with non-severe disease and deceased cases (6.46, 3.40-12.29; = 1%) compared with survivors. Pooled prevalence of CKD was lower in Chinese patients (2.56%; 95% CI, 1.79-3.47%; = 80%) compared to those outside of China (6.32%; 95% CI, 0.9-16.12%; = 93%) ( = 0.08). The summary estimates for AKI prevalence was 11.46% (95% CI, 6.93-16.94%). Patients with AKI had a higher prevalence of developing into severe cases (OR, 6.97; 95% CI, 3.53-13.75; = 0%) and mortality risk (45.79, 36.88-56.85; = 17%). The prevalence estimates of CKD or AKI were not significantly different from preprint publications ( > 0.05). Our study indicates that renal condition, either in CKD or AKI, is associated with COVID-19 prognosis, and taking care of such patients needs further awareness and investigations.
2019冠状病毒病（COVID-19）已被认为与肾脏受累有关，但相关的患病率和预后情况大多未知。在这项荟萃分析中，我们检索了截至2020年4月26日来自PubMed、Embase、bioRxiv和medRxiv的文献。纳入报告慢性肾脏病（CKD）和/或急性肾损伤（AKI）的研究。提取并汇总人口统计学、疾病严重程度的相关数据以及患者的预后情况。纳入了来自52项同行评审研究的21164例患者。37项研究（n = 16922）报告了COVID-19患者诊断时的CKD情况，合并患病率为3.52%（95%CI，1.98 - 5.48%；I² = 93%）。亚组分析显示，与非重症病例相比，重症病例中CKD患病率更高[比值比（OR），3.42；95%CI 2.05 - 5.61；I² = 0%]，与幸存者相比，死亡病例中CKD患病率更高（6.46，3.40 - 12.29；I² = 1%）。与中国以外的患者相比，中国患者中CKD的合并患病率较低（2.56%；95%CI，1.79 - 3.47%；I² = 80%）（P = 0.08）。AKI患病率的汇总估计值为11.46%（95%CI，6.93 - 16.94%）。AKI患者发展为重症病例的患病率更高（OR，6.97；95%CI，3.53 - 13.75；I² = 0%），死亡风险也更高（45.79，36.88 - 56.85；I² = 17%）。CKD或AKI的患病率估计值与预印本出版物无显著差异（P > 0.05）。我们的研究表明，无论是CKD还是AKI，肾脏状况都与COVID-19的预后相关，对这类患者的护理需要进一步关注和研究。
