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新型冠状病毒肺炎与急性肾损伤:一项系统综述

COVID-19 and Acute Kidney Injury: A Systematic Review.

作者信息

Sabaghian Tahereh, Kharazmi Amir Behnam, Ansari Ali, Omidi Fatemeh, Kazemi Seyyedeh Neda, Hajikhani Bahareh, Vaziri-Harami Roya, Tajbakhsh Ardeshir, Omidi Sajjad, Haddadi Sara, Shahidi Bonjar Amir Hashem, Nasiri Mohammad Javad, Mirsaeidi Mehdi

机构信息

Clinical Research Development Center, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Internal Medicine, Imam Hossein Medical Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Front Med (Lausanne). 2022 Apr 4;9:705908. doi: 10.3389/fmed.2022.705908. eCollection 2022.

Abstract

INTRODUCTION

Acute kidney injury (AKI) has been associated with an increased mortality rate among hospitalized patients with Coronavirus disease 2019 (COVID-19). The current review aimed to evaluate the symptoms, complications, and treatments performed to manage AKI in patients with COVID-19.

METHODS

We searched PubMed/Medline, Web of Science, and Embase for the relevant scientific literature published up to February 1, 2022. The following keywords were used: "COVID-19", "SARS-CoV-2", and "Acute kidney injury".

RESULTS

Forty-four studies with a total number of 114 COVID-19 patients with AKI (Mean age: 53.6 years) were included in our systematic review. The most common comorbidities in patients with COVID-19 suffering from AKI were the history of diabetes, hypertension, and hyperlipidemia. Twelve out of the 44 included studies reported a history of chronic kidney disease (CKD) in this group of patients. Focal segmental glomerulosclerosis (FSGS) and acute tubular necrosis (ATN) were the most common pathological evidence. The average length of hospital stay was 19 days, and the average duration of need for mechanical ventilation was 3 days.

CONCLUSIONS

The current systematic review shows that AKI frequently complicates the course of COVID-19 hospitalizations and is associated with increased severity of illness, prolonged duration of hospitalization, and poor prognosis. Given the extent of the adverse impact of AKI, early detection of comorbidities and renal complications is essential to improve the outcomes of COVID-19 patients.

摘要

引言

急性肾损伤(AKI)与2019冠状病毒病(COVID-19)住院患者死亡率增加有关。本综述旨在评估COVID-19患者中AKI的症状、并发症及治疗措施。

方法

我们在PubMed/Medline、科学网和Embase中检索截至2022年2月1日发表的相关科学文献。使用了以下关键词:“COVID-19”、“严重急性呼吸综合征冠状病毒2(SARS-CoV-2)”和“急性肾损伤”。

结果

我们的系统评价纳入了44项研究,共114例COVID-19合并AKI患者(平均年龄:53.6岁)。COVID-19合并AKI患者最常见的合并症为糖尿病史、高血压史和高脂血症史。44项纳入研究中有12项报告了该组患者的慢性肾脏病(CKD)病史。局灶节段性肾小球硬化(FSGS)和急性肾小管坏死(ATN)是最常见的病理证据。平均住院时间为19天,平均机械通气时间为3天。

结论

当前的系统评价表明,AKI常使COVID-19住院病程复杂化,并与疾病严重程度增加、住院时间延长和预后不良相关。鉴于AKI的不利影响程度,早期发现合并症和肾脏并发症对于改善COVID-19患者的预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be13/9014846/8ab3c0b8dec8/fmed-09-705908-g0001.jpg

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