Renal complications in COVID-19: a systematic review and meta-analysis
Creators: name: Setor K. Kunutsor
name: Laukkanen, Jari A.
Publisher: name: Taylor & Francis
Year: 2020
Subjects: subject: Medicine
subject: Pharmacology
subject: Biotechnology
subject: Immunology
subject: FOS: Clinical medicine
subject: FOS: Clinical medicine
subject: 69999 Biological Sciences not elsewhere classified
subject: FOS: Biological sciences
subject: FOS: Biological sciences
subject: 19999 Mathematical Sciences not elsewhere classified
subject: FOS: Mathematics
subject: FOS: Mathematics
subject: Developmental Biology
subject: Marine Biology
subject: Science Policy
subject: Computational Biology

description: Emerging data suggest that coronavirus disease 2019 (COVID-19) has extrapulmonary manifestations but its renal manifestations are not clearly defined. We aimed to evaluate renal complications of COVID-19 and their incidence using a systematic meta-analysis. Observational studies reporting renal complications in COVID-19 patients were sought from MEDLINE, Embase and the Cochrane Library from 2019 to June 2020. The nine-star Newcastle-Ottawa Scale was used to evaluate methodological quality. Incidence with 95% confidence intervals (CIs) were pooled using random-effects models. We included 22 observational cohort studies comprising of 17,391 COVID-19 patients. Quality scores of studies ranged from 4 to 6. The pooled prevalence of pre-existing chronic kidney disease (CKD) and end-stage kidney disease was 5.2% (2.8–8.1) and 2.3% (1.8–2.8), respectively. The pooled incidence over follow-up of 2–28 days was 12.5% (10.1–15.0) for electrolyte disturbance (e.g. hyperkalaemia), 11.0% (7.4–15.1) for acute kidney injury (AKI) and 6.8% (1.0–17.0) for renal replacement therapy (RRT). In subgroup analyses, there was a higher incidence of AKI in US populations and groups with higher prevalence of pre-existing CKD. Frequent renal complications reported among hospitalized COVID-19 patients are electrolyte disturbance, AKI and RRT. Aggressive monitoring and management of these renal complications may help in the prediction of favourable outcomes. <b>Systematic review registration:</b> PROSPERO 2020: CRD42020186873KEY MESSAGESCOVID-19 affects multiple organs apart from the respiratory system; however, its renal manifestations are not clearly defined.In this systematic meta-analysis of 22 observational cohort studies, the prevalence of pre-existing chronic kidney disease (CKD) in COVID-19 patients was 5.2%.The most frequent renal complication was electrolyte disturbance (particularly hyperkalaemia) with an incidence of 12.5% followed by acute kidney injury (AKI) with an incidence of 11.0%; US populations and groups with higher prevalence of CKD had higher incidence of AKI. COVID-19 affects multiple organs apart from the respiratory system; however, its renal manifestations are not clearly defined. In this systematic meta-analysis of 22 observational cohort studies, the prevalence of pre-existing chronic kidney disease (CKD) in COVID-19 patients was 5.2%. The most frequent renal complication was electrolyte disturbance (particularly hyperkalaemia) with an incidence of 12.5% followed by acute kidney injury (AKI) with an incidence of 11.0%; US populations and groups with higher prevalence of CKD had higher incidence of AKI.