Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Department of Emergency and Organ Transplantation, Nephrology Dialysis and Transplantation Unit, "Aldo Moro" University, Bari, Italy.
Adv Exp Med Biol. 2021;1321:309-324. doi: 10.1007/978-3-030-59261-5_28.
Acute kidney injury (AKI) is a fatal complication of the new severe acute respiratory syndrome coronavirus (SARS-CoV-2) which causes COVID-19 disease. Here, we performed a scoping review and meta-analysis including clinical studies on patients with SARS-CoV-2 infection with data on AKI assessment and characteristics, and the overall prevalence of AKI was estimated using a random-effects model. We identified 21 articles which passed the search criteria. All were quantitative observational studies which used a cross-sectional, retrospective, case report, or cohort methodology. This showed that aging, diabetes, cardiovascular disease, previous chronic disease, and other comorbidities were risk factors of AKI. Although the prevalence of proteinuria, hematuria, and increased serum creatinine was reported for up to 60% of the patients with COVID-19, the overall prevalence of AKI was estimated to be 8%. We conclude that although approximately two-thirds of patients with COVID-19 had symptoms of kidney damage, most of these did not meet the diagnostic criteria for AKI. Further studies should be performed to validate biomarkers for improved AKI diagnosis in COVID-19 patients and new treatment options are required to reduce the rate of mortality.
急性肾损伤（AKI）是新型严重急性呼吸综合征冠状病毒（SARS-CoV-2）引起的 COVID-19 疾病的致命并发症。在这里，我们进行了范围审查和荟萃分析，包括对 SARS-CoV-2 感染患者的临床研究，这些研究的数据涉及 AKI 的评估和特征，以及使用随机效应模型估计 AKI 的总体患病率。我们确定了 21 篇符合搜索标准的文章。所有这些文章都是定量观察性研究，采用了横断面、回顾性、病例报告或队列方法学。这表明，年龄、糖尿病、心血管疾病、既往慢性疾病和其他合并症是 AKI 的危险因素。尽管高达 60%的 COVID-19 患者报告有蛋白尿、血尿和血清肌酐升高的症状，但 AKI 的总体患病率估计为 8%。我们得出结论，尽管大约三分之二的 COVID-19 患者有肾脏损伤的症状，但其中大多数不符合 AKI 的诊断标准。需要进一步的研究来验证 COVID-19 患者中用于改善 AKI 诊断的生物标志物，并需要新的治疗方法来降低死亡率。
