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Abstract: PO0664

Incidence of AKI and Its Association with Mortality in Coronavirus Disease 2019 (COVID-19) Patients: A Meta-Analysis

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Hansrivijit, Panupong, UPMC Pinnacle, Harrisburg, Pennsylvania, United States
  • Boonpheng, Boonphiphop, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Thongprayoon, Charat, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Cheungpasitporn, Wisit, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Ghahramani, Nasrollah, Penn State College of Medicine, Hershey, Pennsylvania, United States
Background

Acute kidney injury (AKI) is a common complication in medical practice accounting from 8-18% of hospitalized patients. However, although it has been well-established that AKI is linked to increased mortality in hospitalized patients, whether this knowledge would extend to Coronavirus Disease 2019 (COVID-19) patients remained unanswered. Thus, this study aimed to determine the incidence of AKI and its association with mortality in COVID-19 patients from available literatures using a systematic review and meta-analysis.

Methods

We search Ovid MEDLINE, EMBASE, and the Cochrane Library for eligible publications reporting the clinical characteristics of confirmed COVID-19 patients without language restriction. Incidence of AKI and mortality were reported. Because COVID-19 is an emerging pandemic, a large number of studies were published within a short period of time. Valid Institutional Review Board (IRB) number or approval by the National Health Commission of that country were screened to avoid studies with duplicated patients' population.

Results

From 26 studies (n = 5,497), the pooled incidence of AKI in COVID-19 patients was 8.4% (95% CI, 6.0-11.7) with a pooled incidence of renal replacement therapy of 3.6% (95% CI, 1.8-7.1). The incidence of AKI was higher in critically ill patients (19.9%) compared to hospitalized patients (7.3%). Critically ill patients had higher mortality than hospitalized patients. (33% vs. 16.1%, respectively). The pooled estimated unadjusted odds ratio for mortality from AKI was 13.33 (95% CI, 4.05-43.91). By using meta-regression analyses, the incidence of AKI was positively associated with mortality in an adjusted model (Q 26.18; p = 0.02). Moreover, our adjusted model showed that age (p < 0.01), diabetes (p = 0.02), hypertension (p < 0.01) and baseline serum creatinine levels (p = 0.04) were positively associated with the incidence of AKI.

Conclusion

AKI is present in 8.3% of overall COVID-19 patients and in 19.9% of critically ill COVID-19 patients. Presence of AKI is associated with 13-fold increased risk of mortality. Age, diabetes, hypertension, and baseline serum creatinine levels are associated with increased AKI incidence. More studies, including the ones from multi-national databases, are encouraged to confirm our findings.