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急性肾损伤及其与亚洲 COVID-19 患者死亡率的关系:一项荟萃分析。

Acute kidney injury and its association with mortality in Asian COVID-19 patients: A meta-analysis.

出版信息

Clin Nephrol. 2022 Oct;98(4):188-197. doi: 10.5414/CN110899.

Abstract

BACKGROUND

Previous evidence suggests that acute kidney injury (AKI) is common in patients with COVID-19 and associated with adverse outcomes. Moreover, the incidence and mortality of AKI in Asia are ambiguous.

OBJECTIVE

Evaluating the risk factors and risk of death from AKI in -COVID-19 patients in Asia.

MATERIALS AND METHODS

We conducted a meta-analysis of clinical observational studies of -COVID-19 patients in Asia. Outcome measures included: AKI in COVID-19 patients, overall mortality in COVID-19 patients, and mortality assessment in patients with AKI. The random-effects model was adopted, with heterogeneity and sensitivity analysis.

RESULTS

27 clinical studies (18,216 Asian patients with COVID-19) have been included in the study. The pooled incidence of AKI was 0.19 (95% CI 16 - 23%; I = 98.9%, p < 0.001); the pooled incidence of total mortality was 0.19 (95% CI 17 - 22%; I = 98.9%, p < 0.001). No publication bias was found (Egger's test, p = 0.396, 0.213). The pooled mortality in AKI patients with COVID-19 was 50% (95% CI 33 - 67%; I by random-effects model = 98.4%, p < 0.001). AKI was found to be a risk factor for death in stepwise regression analysis; age, diabetes, and hypertension were influencing factors for AKI risk in -COVID-19 patients.

CONCLUSION

AKI is a common complication in Asian COVID-19 patients, and it is associated with an increase in mortality of Asian COVID-19 patients. Any treatment that protects the kidney may be a practical intervention to reduce the mortality of COVID-19 patients in Asia.

摘要

背景

先前的证据表明,急性肾损伤(AKI)在 COVID-19 患者中很常见,并与不良结局相关。此外,亚洲地区 AKI 的发病率和死亡率尚不清楚。

目的

评估亚洲 COVID-19 患者中 AKI 的危险因素和死亡风险。

材料与方法

我们对亚洲 COVID-19 患者的临床观察性研究进行了荟萃分析。结局指标包括:COVID-19 患者中的 AKI、COVID-19 患者的总体死亡率以及 AKI 患者的死亡率评估。采用随机效应模型,进行异质性和敏感性分析。

结果

纳入了 27 项临床研究(18216 例亚洲 COVID-19 患者)。AKI 的汇总发生率为 0.19(95%CI 16-23%;I=98.9%,p<0.001);总死亡率的汇总发生率为 0.19(95%CI 17-22%;I=98.9%,p<0.001)。未发现发表偏倚(Egger 检验,p=0.396,0.213)。COVID-19 合并 AKI 患者的汇总死亡率为 50%(95%CI 33-67%;随机效应模型 I=98.4%,p<0.001)。逐步回归分析发现 AKI 是死亡的危险因素;年龄、糖尿病和高血压是 COVID-19 患者发生 AKI 的影响因素。

结论

AKI 是亚洲 COVID-19 患者的常见并发症,与亚洲 COVID-19 患者死亡率增加相关。任何保护肾脏的治疗都可能是降低亚洲 COVID-19 患者死亡率的实际干预措施。

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