Vakhshoori Mehrbod, Emami Sayed Ali, Heidarpour Maryam, Shafie Davood, Mortazavi Mojgan
Heart Failure Research Center, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Iran J Kidney Dis. 2020 Dec;14(6):419-438.
Coronavirus disease 2019 (COVID-19) has been recently emerged with various manifestations, mainly on respiratory system. However, other organs might also be involved. Acute kidney injury has been reported as a complication with high variability and controversial results. We aimed to define the frequency of AKI as well as two specific renal biomarkers including BUN and serum Cr among individuals suffering from COVID-19 infection. We investigated Medline/PubMed, Scopus, and Google Scholar databases until 16th April 2020 and included all relevant peer-reviewed published studies without any language limitations. We further categorized patients according to their clinical status into severe, non-severe, and death groups. 18 records on 4528 individuals were assessed. The mean age of individuals were 52.5 ± 24.4 years (males: 55.6%). Prevalence of AKI was 4% (95% CI: 2% to 8%) and was significantly lower among non-severe patients in comparison to deceased ones (1%, 95% CI: 0% to 4%, vs. 31%, 95% CI: 19% to 47%). BUN mean was 5.14 mmol/L (95% CI: 4.60 to 5.69). Non-severe patients had remarkably lower means of BUN compared to deceased or those with severe infection (4.25 mmol/L, 95% Cl: 3.70 to 4.79, vs. 8.9 mmol/L, 95% CI: 7.94 to 9.86, vs. 6.63 mmol/L, 95% Cl: 5.62 to 7.65; respectively). The mean serum Cr was 71.60 mmol/L (95% Cl: 67.56 to 75.64). Our findings suggest that COVID-19 does not seem to involve renal system extensively and other possible mechanisms might be further investigated in this regard.
2019年冠状病毒病（COVID-19）最近出现了各种表现，主要累及呼吸系统。然而，其他器官也可能受累。急性肾损伤已被报道为一种并发症，其变异性高且结果存在争议。我们旨在确定COVID-19感染患者中急性肾损伤（AKI）的发生率以及两种特定的肾脏生物标志物，即血尿素氮（BUN）和血清肌酐（Cr）。我们检索了截至2020年4月16日的Medline/PubMed、Scopus和谷歌学术数据库，纳入了所有相关的、经过同行评审的已发表研究，无语言限制。我们根据患者的临床状况将其进一步分为重症、非重症和死亡组。对4528名个体的18份记录进行了评估。个体的平均年龄为52.5±24.4岁（男性：55.6%）。AKI的患病率为4%（95%置信区间：2%至8%），与死亡患者相比，非重症患者中的患病率显著较低（1%，95%置信区间：0%至4%，与31%，95%置信区间：19%至47%）。BUN的平均值为5.14 mmol/L（95%置信区间：4.60至5.69）。与死亡患者或重症感染患者相比，非重症患者的BUN平均值显著较低（分别为4.25 mmol/L，95%置信区间：3.70至4.79，与8.9 mmol/L，95%置信区间：7.94至9.86，与6.63 mmol/L，95%置信区间：5.62至7.65）。血清Cr的平均值为71.60 mmol/L（95%置信区间：67.56至75.64）。我们的研究结果表明，COVID-19似乎并未广泛累及肾脏系统，在这方面可能需要进一步研究其他可能的机制。
