School of Pharmaceutical Sciences, University Sains Malaysia, Penang, 11800, Malaysia.
Iqra University, H-9 Campus, Islamabad, 44000, Pakistan.
BMC Nephrol. 2024 Nov 6;25(1):399. doi: 10.1186/s12882-024-03821-6.
BACKGROUND: Recent reports have revealed that nephropathy leading to kidney injury (KI) is a prevalent complication of COVID-19 and is linked to high mortality and morbidity in diabetes mellitus type II (DM-T-II) patients. This systematic literature review and meta-analysis aimed to critically analyze existing studies and evidence on the impact of COVID-19 on nephropathy and kidney injury in diabetes mellitus type II (DM-T-II) patients. METHOD: A systematic search was conducted in the Web of Science (WoS), PubMed and Cochrane databases for relevant studies published between March 2020 and July 2023. To ensure the integrity of the systematic literature review and meta-analysis, observational studies that specifically reported post-COVID-19 kidney injury in DM-T2 patients were included, whereas we did not include articles in the press, meta-analyses, case reports, case series, Diabetes Type-I articles or non-English papers. The primary outcome was kidney injury in patients with type II diabetes after contracting COVID-19. The protocol for this study was published on PROSPERO (registration number CRD42023413887). RESULTS: Initially, 6,339 articles were included in the search, from which only 6 observational studies were selected by following the 2020 PRISMA statement. The quality of the evidence was assessed by a tool provided by the National Institutes of Health (observational studies). The total number of participants included in the studies was 14,723. Our systematic literature review and meta-analysis provide compelling evidence that kidney injury is a prevalent complication of COVID-19 infection in the type II diabetes population, with a pooled odds ratio of 2.27 (95% CI: 2.05-2.51; p < 0.00001), often necessitating hospitalization and hemodialysis in severe cases. CONCLUSION: Covid-19 is associated with a two-fold increase in nephropathy and acute kidney injury in diabetes mellitus type 2 patients compared to non-diabetic patients. This implies that kidney injury is more likely to occur in diabetes mellitus type 2 patients post Covid infection.
背景：最近的报告显示，导致肾损伤（KI）的肾病是 COVID-19 的一种普遍并发症，与 II 型糖尿病（DM-T-II）患者的高死亡率和发病率有关。本系统文献回顾和荟萃分析旨在批判性分析现有研究和证据，了解 COVID-19 对 II 型糖尿病（DM-T-II）患者的肾病和肾损伤的影响。
方法：在 Web of Science（WoS）、PubMed 和 Cochrane 数据库中进行了系统搜索，以查找 2020 年 3 月至 2023 年 7 月期间发表的相关研究。为确保系统文献回顾和荟萃分析的完整性，我们纳入了专门报告 DM-T2 患者感染 COVID-19 后肾损伤的观察性研究，而不包括新闻文章、荟萃分析、病例报告、病例系列、I 型糖尿病文章或非英语论文。主要结局是 II 型糖尿病患者感染 COVID-19 后的肾损伤。本研究的方案已在 PROSPERO（注册号 CRD42023413887）上公布。
结果：最初，搜索中包括了 6339 篇文章，其中只有 6 项观察性研究符合 2020 年 PRISMA 声明的标准。使用美国国立卫生研究院提供的工具评估证据质量（观察性研究）。纳入研究的总人数为 14723 人。我们的系统文献回顾和荟萃分析提供了有力的证据，表明在 II 型糖尿病人群中，肾损伤是 COVID-19 感染的常见并发症，合并比值比为 2.27（95%CI：2.05-2.51；p<0.00001），在严重情况下常需要住院和血液透析。
结论：与非糖尿病患者相比，COVID-19 使 2 型糖尿病患者的肾病和急性肾损伤风险增加一倍。这意味着 COVID-19 感染后，II 型糖尿病患者更有可能发生肾损伤。
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