Acute kidney injury in patients with COVID-19 compared to those with influenza: a systematic review and meta-analysis

BACKGROUND: COVID-19 and influenza can both lead to acute kidney injury (AKI) as a common complication. However, no meta-analysis has been conducted to directly compare the incidence of AKI between hospitalized patients with COVID-19 and influenza. The objective of our study aims to investigate the...

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Detalles Bibliográficos
Autores principales: Hsiao, Chiu-Ying, Pan, Heng-Chih, Wu, Vin-Cent, Su, Ching-Chun, Yeh, Tzu-Hsuan, Chuang, Min-Hsiang, Tu, Kuan-Chieh, Wang, Hsien-Yi, Kan, Wei-Chih, Yang, Chun-Chi, Chen, Jui-Yi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Medicine
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547056/
https://www.ncbi.nlm.nih.gov/pubmed/37795409
http://dx.doi.org/10.3389/fmed.2023.1252990
Descripción
Sumario:BACKGROUND: COVID-19 and influenza can both lead to acute kidney injury (AKI) as a common complication. However, no meta-analysis has been conducted to directly compare the incidence of AKI between hospitalized patients with COVID-19 and influenza. The objective of our study aims to investigate the incidence and outcomes of AKI among hospitalized patients between these two groups. MATERIALS AND METHODS: A systematic search of PubMed, Embase, and Cochrane databases was conducted from December 2019 to August 2023 to identify studies examining AKI and clinical outcomes among hospitalized patients with COVID-19 and influenza. The primary outcome of interest was the incidence of AKI, while secondary outcomes included in-hospital mortality, recovery from AKI, hospital and ICU stay duration. The quality of evidence was evaluated using Cochrane and GRADE methods. RESULTS: Twelve retrospective cohort studies, involving 17,618 hospitalized patients with COVID-19 and influenza, were analyzed. COVID-19 patients showed higher AKI incidence (29.37% vs. 20.98%, OR: 1.67, 95% CI 1.56–1.80, p < 0.01, I(2) = 92.42%), and in-hospital mortality (30.95% vs. 5.51%, OR: 8.16, 95% CI 6.17–10.80, p < 0.01, I(2) = 84.92%) compared to influenza patients with AKI. Recovery from AKI was lower in COVID-19 patients (57.02% vs., 80.23%, OR: 0.33, 95% CI 0.27–0.40, p < 0.01, I(2) = 85.17%). COVID-19 patients also had a longer hospital stay (SMD: 0.69, 95% CI 0.65–0.72, p < 0.01, I(2) = 98.94%) and longer ICU stay (SMD: 0.61, 95% CI 0.50–0.73, p < 0.01, I(2) = 94.80%) than influenza patients. In our study, evidence quality was high (NOS score 7–9), with low certainty for AKI incidence and moderate certainty for recovery form AKI by GRADE assessment. CONCLUSION: COVID-19 patients had higher risk of developing AKI, experiencing in-hospital mortality, and enduring prolonged hospital/ICU stays in comparison to influenza patients. Additionally, the likelihood of AKI recovery was lower among COVID-19 patients.

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