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The proportion of different stages of AKI. AKI was staged according to severity based on the KDIGO guideline. Of these patients, 8 (22.2%), 2 (5.6%), and 26 (72.2%) were diagnosed with stages 3, 2, and 1 kidney disease, respectively. AKI = acute kidney injury; KDIGO = Kidney Disease Improving Global Outcomes.
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Background:
Since the first diagnosed case of infection with the novel coronavirus (SARS-CoV-2), there has been a rapid spread of the disease with an increasing number of cases confirmed every day, as well as a rising death toll. An association has been reported between acute kidney injury (AKI) and mortality in patients infected with SARS-CoV-2....
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Background
Acute kidney injury (AKI) occurs among patients with coronavirus disease-19 (COVID-19) and has also been indicated to be associated with in-hospital mortality. Remdesivir has been authorized for the treatment of COVID-19. We conducted a systematic review to evaluate the incidence of AKI in hospitalized COVID-19 patients. The incidence of...
Citations
... (Figure 1). All the studies included were published in English, between 2020 and 2022, carried out in South America (16)(17)(18)(19) and North America, (20)(21)(22)(23)(24)(25)(26)(27) Asia, (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) Europe, (43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53) Africa (54) and Middle East. (55)(56)(57)(58) The country with the highest number of publications on AKI associated with COVID-19 was China, with 27.3% (n = 12) of the articles. ...
... (55)(56)(57)(58) The country with the highest number of publications on AKI associated with COVID-19 was China, with 27.3% (n = 12) of the articles. (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) All the studies were observational, with a predominance of cohorts 63.6% (n=28), (16,17,20,21,23,28,29,(31)(32)(33)(35)(36)(37)(38)40,41,(43)(44)(45)(46)(51)(52)(53)(55)(56)(57)(58)(59) 77,3% (n = 34) retrospective (16)(17)(18)20,21,(24)(25)(26)(27)(28)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(46)(47)(48)(49)(50)(51)(52)(53)55) and 2,3% (n = 1) prospective. (19) All the included studies had a level of evidence IV. ...
... (55)(56)(57)(58) The country with the highest number of publications on AKI associated with COVID-19 was China, with 27.3% (n = 12) of the articles. (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) All the studies were observational, with a predominance of cohorts 63.6% (n=28), (16,17,20,21,23,28,29,(31)(32)(33)(35)(36)(37)(38)40,41,(43)(44)(45)(46)(51)(52)(53)(55)(56)(57)(58)(59) 77,3% (n = 34) retrospective (16)(17)(18)20,21,(24)(25)(26)(27)(28)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(46)(47)(48)(49)(50)(51)(52)(53)55) and 2,3% (n = 1) prospective. (19) All the included studies had a level of evidence IV. ...
... (Figure 1). All the studies included were published in English, between 2020 and 2022, carried out in South America (16)(17)(18)(19) and North America, (20)(21)(22)(23)(24)(25)(26)(27) Asia, (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) Europe, (43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53) Africa (54) and Middle East. (55)(56)(57)(58) The country with the highest number of publications on AKI associated with COVID-19 was China, with 27.3% (n = 12) of the articles. ...
... (55)(56)(57)(58) The country with the highest number of publications on AKI associated with COVID-19 was China, with 27.3% (n = 12) of the articles. (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) All the studies were observational, with a predominance of cohorts 63.6% (n=28), (16,17,20,21,23,28,29,(31)(32)(33)(35)(36)(37)(38)40,41,(43)(44)(45)(46)(51)(52)(53)(55)(56)(57)(58)(59) 77,3% (n = 34) retrospective (16)(17)(18)20,21,(24)(25)(26)(27)(28)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(46)(47)(48)(49)(50)(51)(52)(53)55) and 2,3% (n = 1) prospective. (19) All the included studies had a level of evidence IV. ...
... (55)(56)(57)(58) The country with the highest number of publications on AKI associated with COVID-19 was China, with 27.3% (n = 12) of the articles. (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) All the studies were observational, with a predominance of cohorts 63.6% (n=28), (16,17,20,21,23,28,29,(31)(32)(33)(35)(36)(37)(38)40,41,(43)(44)(45)(46)(51)(52)(53)(55)(56)(57)(58)(59) 77,3% (n = 34) retrospective (16)(17)(18)20,21,(24)(25)(26)(27)(28)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(46)(47)(48)(49)(50)(51)(52)(53)55) and 2,3% (n = 1) prospective. (19) All the included studies had a level of evidence IV. ...
Objective: To identify the frequency of acute kidney injury (AKI) in patients hospitalized with COVID-19, associated characteristics, mortality and lethality. Methods: Integrative review carried out in the databases CINAHL, Embase, LILACS, Livivo, PubMed, SCOPUS, Web of Science and in the grey literature (Google Scholar) on January 12, 2022. Articles were included in English, Spanish and Portuguese, published from November 2019 to January 2022, in hospitalized patients over 18 years old with COVID-19 and AKI according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The selected studies were read in full for extraction, interpretation, synthesis and categorization according to the level of evidence. Results: A total of 699 articles were found and 45 included. Older age, male gender, hypertension, chronic kidney disease, mechanical ventilation, increased C-reactive protein, use of vasoactive drugs and certain classes of antihypertensives were associated with AKI. AKI is related to a higher frequency of mortality. AKI occurred in 30% of patients hospitalized with COVID-19. The mortality rate from AKI was 5% and the case fatality rate was 18%. Conclusion: These results highlight the relevance of AKI as a significant complication of COVID-19 and suggest that more careful and early control of associated factors could potentially reduce mortality and lethality. It is crucial to intensify research in this field to better clarify the mechanisms involved in kidney injury in COVID-19 patients, as well as to identify more effective therapeutic strategies for its prevention and treatment in this context.
... To date, however, there has been little definitive evidence that it is so [9,[20][21][22][23][24][25][26][27]. Additionally, diuretic use was independently associated with an increased risk of AKI among the hospitalized Covid-19 patients which is a disease characterized with widespread inflammation [11,28,29]. Besides, we demonstrated that furosemide disrupts kidney perfusion after IR insult without effecting the systemic hemodynamic parameters. ...
Abstract Background Perioperative acute kidney injury (AKI) caused by ischemia–reperfusion (IR) is a significant contributor to mortality and morbidity after major surgery. Furosemide is commonly used in postoperative patients to promote diuresis and reduce tissue edema. However, the effects of furosemide on renal microcirculation, oxygenation and function are poorly understood during perioperative period following ischemic insult. Herein, we investigated the effects of furosemide in rats subjected IR insult. Methods 24 Wistar albino rats were divided into 4 groups, with 6 in each; Sham-operated Control (C), Control + Furosemide (C + F), ischemia/reperfusion (IR), and IR + F. After induction of anesthesia (BL), supra-aortic occlusion was applied to IR and IR + F groups for 45 min followed by ongoing reperfusion for 15 min (T1) and 2 h (T2). Furosemide infusion was initiated simultaneously in the intervention groups after ischemia. Renal blood flow (RBF), vascular resistance (RVR), oxygen delivery (DO2ren) and consumption (VO2ren), sodium reabsorption (TNa+), oxygen utilization efficiency (VO2/TNa+), cortical (CμO2) and medullary (MμO2) microvascular oxygen pressures, urine output (UO) and creatinine clearance (Ccr) were measured. Biomarkers of inflammation, oxidative and nitrosative stress were measured and kidneys were harvested for histological analysis. Results IR significantly decreased RBF, mainly by increasing RVR, which was exacerbated in the IR + F group at T2 (2198 ± 879 vs 4233 ± 2636 dyne/s/cm5, p = 0.07). CμO2 (61.6 ± 6.8 vs 86 ± 6.6 mmHg) and MμO2 (51.1 ± 4.1 vs 68.7 ± 4.9 mmHg, p
... The study by Robbins-Juarez et al showed that AKI was related to the increased risk of mortality among COVID-19 patients, which was similar to our findings (16). The death rate in AKI cases was 63.9% in the study by Dai et al, which was substantially higher than in patients without AKI (17). Patients with AKI also had a higher death rate in the study by Xiao et al (14). ...
Introduction: Acute kidney injury (AKI) is prevalent in the coronavirus disease-2019 (COVID-19). There are little data on the relationship between renal dysfunction and COVID-19 prognosis. Objectives: The aim of this research was to investigate the effects of AKI in COVID-19 patients hospitalized to the Golestan and Razi hospitals in Ahvaz, Iran. Patients and Methods: In this retrospective cohort study, a total of 194 COVID-19 patients were included, consisting of 79 patients with AKI and 115 patients without AKI. Primary and secondary outcomes were compared between the two groups. Results: According to the findings, mortality was significantly different between the two groups, and mortality was higher in the AKI group (P< 0.001). The mean length of hospital stay was statistically significantly higher in the AKI group (P=0.024). Moreover, there was a significant correlation between intensive care unit (ICU) admission and the study group (P<0.001). Staging of AKI group were seen as; stage I (49.37%), stage II (36.71%), and stage III (13.92%). No significant correlation was observed between outcome and the stages of AKI (P=0.496). Furthermore, 14 patients (17.72%) needed renal replacement therapy (RRT) in the AKI group. Conclusion: Although AKI is a common finding in COVID-19 patients, most patients were in stage I disease, which returned to normal after COVID-19 treatment. According to our research, COVID-19 rarely leads to serious and persistent kidney injury. However, the risk of death is increased in COVID-19 patients with AKI. Therefore, it is necessary to evaluate the renal function tests during the course of disease.
... Other drugs related to AKI in COVID-19 patients were hydroxychloroquine (707 patients) and azithromycin (546 patients). 32 **** * *** Good quality Hirsch et al (2020) 15 **** ** *** Good quality Fominskiy et al (2020) 34 **** ** *** Good quality Dai et al (2021) 35 **** ** *** Good quality Zheng et al (2020) 36 **** * *** Good quality Na et al (2020) 14 **** ** *** Good quality Trabulus et al (2020) Information about the influence of AKI and the use of mechanical ventilation in patients hospitalized for COVID-19 presented in the articles was extracted and statistically analyzed. In most articles, there was a greater number of deaths in patients who presented AKI during hospitalization compared to those without AKI. ...
... Comorbidities in patients with COVID-19 associated with acute kidney injury10,14,15,17,24,25,29,31,32,[34][35][36][37][38]40,[42][43][44][45][46][47][48] . ...
... Drugs used in patients with COVID-1910,14,15,17,24,25,29,31,32,[34][35][36][37][38]40,[42][43][44][45][46][47][48]50, . ...
Background:
Acute kidney injury (AKI) is a frequent complication of coronavirus-19 disease (COVID-19). Therefore, we decided to perform a systematic review and meta-analysis with data from the literature to relate the development of COVID-19 associated-AKI with comorbidities, medications, and the impact of mechanical ventilation.
Methods:
We performed a systematic review using the Newcastle-Ottawa scale and a meta-analysis using the R program. Relevant studies were searched in the PubMed, Medline, and SciELO electronic databases. Search filters were used to include reports after 2020 and cohort studies.
Results:
In total, 1166 articles were identified and 55 English-written articles were included based on the risk of bias. Of all COVID-19-hospitalized patients presenting with AKI (n = 18029) classified as Kidney Disease Improving Global Outcomes stage 1 to 3, approximately 18% required mechanical ventilation and 39.2 % died. Around 11.3% of the patients required kidney replacement therapy (KRT) and of these, 1093 died and 321 required continuous KRT. Death is more frequent in individuals with AKI [OR 6.03, 95%CI: 5.73-6.74; p<0.01]. Finally, mechanical ventilation is an aggravating factor in the clinical conditions studied [OR 11.01, 95%CI: 10.29-11.77; p<0.01].
Conclusion:
Current literature indicates AKI as an important complication in COVID-19. In this context, we observed that comorbidities, such as chronic kidney disease and heart failure, were more related to the development of AKI. In addition, mechanical ventilation was seen as an aggravating factor in this scenario.
... No item sobre comparabilidade, os artigos foram classificados com base na quantidade de informações disponíveis para análise de dados e resultados. (2020) 10,14,15,17,24,25,29,31,32,[34][35][36][37][38]40,[42][43][44][45][46][47][48] . Informações sobre a influência da LRA e o uso de ventilação mecânica em pacientes hospitalizados por COVID-19 apresentadas nos artigos foram extraídas e analisadas estatisticamente. ...
... Medicamentos utilizados em pacientes com COVID-1910,14,15,17,24,25,29,31,32,[34][35][36][37][38]40,[42][43][44][45][46][47][48]50, . ...
Resumo Antecedentes: Lesão renal aguda (LRA) é uma complicação frequente da doença do coronavírus-19 (COVID-19). Desta forma, decidimos realizar uma revisão sistemática e uma metanálise com dados da literatura para relacionar o desenvolvimento de LRA associada à COVID-19 com comorbidades, medicamentos e o impacto da ventilação mecânica. Métodos: Realizamos uma revisão sistemática usando a escala de Newcastle-Ottawa e uma metanálise utilizando o programa R. Estudos relevantes foram pesquisados nos bancos de dados eletrônicos PubMed, Medline e SciELO. Foram utilizados filtros de pesquisa para incluir relatos após 2020 e estudos de coorte. Resultados: No total, foram identificados 1166 artigos, e foram incluídos 55 artigos escritos em língua inglesa com base no risco de viés. De todos os pacientes hospitalizados por COVID-19 apresentando LRA (n = 18029) classificados como Kidney Disease Improving Global Outcomes estágios 1 a 3, aproximadamente 18% necessitaram de ventilação mecânica e 39,2% foram a óbito. Cerca de 11,3% dos pacientes necessitaram de terapia renal substitutiva (TRS) e destes, 1093 foram a óbito e 321 necessitaram de TRS contínua. O óbito é mais frequente em indivíduos com LRA [OR 6,03; IC95%: 5,73-6,74; p<0,01]. Por fim, a ventilação mecânica é um fator agravante nas condições clínicas estudadas [OR 11,01; IC95%: 10,29-11,77; p<0,01]. Conclusão: A literatura atual indica a LRA como uma complicação importante na COVID-19. Neste contexto, observamos que comorbidades, como doença renal crônica e insuficiência cardíaca, estiveram mais relacionadas ao desenvolvimento de LRA. Além disso, a ventilação mecânica foi vista como um fator agravante neste cenário.
... We identified the data by searching PubMed and references from relevant articles using the search terms "Coronavirus Disease 2019", "COVID-19", "SARS-CoV-2", "kidney disease", "acute kidney injury", "AKI", "risk factors", "gender", "clinical outcomes", and "Clinical Characteristics". We found that the SARS-CoV-2 infection rate in males is higher than that in females, and the incidence of AKI in males is also higher than that in females in most studies (Figures 1, 2) (Cheng et al., 2020b;Fisher et al., 2020;Hirsch et al., 2020;Kolhe et al., 2020;Pei et al., 2020;Sang et al., 2020;Zahid et al., 2020;Basalely et al., 2021;Chan et al., 2021;Cheng et al., 2021;Costa et al., 2021;Dai et al., 2021;Diebold et al., 2021;Gasparini et al., 2021;Martinez-Rueda et al., 2021;Mousavi Movahed et al., 2021;Ng et al., 2021;Ozturk et al., 2021;Russo et al., 2021;Xu J. et al., 2021;Yildirim et al., 2021;Zamoner et al., 2021). In these studies, all of the patients with COVID-19 had new-onset AKI during hospitalization. ...
... In addition to the higher proportion of males in AKI patients, the incidence of AKI in male patients with COVID-19 is also higher than that in female patients ( Figure 2) (Cheng et al., 2020b;Fisher et al., 2020;Hirsch et al., 2020;Kolhe et al., 2020;Pei et al., 2020;Sang et al., 2020;Zahid et al., 2020;Basalely et al., 2021;Chan et al., 2021;Cheng et al., 2021;Costa et al., 2021;Dai et al., 2021;Diebold et al., 2021;Gasparini et al., 2021;Martinez-Rueda et al., 2021;Mousavi Movahed et al., 2021;Ng et al., 2021;Ozturk et al., 2021;Russo et al., 2021;Xu J. et al., 2021;Yildirim et al., 2021;Zamoner et al., 2021). According to the previously mentioned mechanism of SARS-CoV-2 directly invading kidney host cells to cause AKI, ACE2 and TMPRSS2 are expressed in proximal convoluted tubule cells and podocytes (He et al., 2020). ...
Coronavirus disease 2019(COVID-19) has become a public health emergency of concern worldwide. COVID-19 is a new infectious disease arising from Coronavirus 2 (SARS-CoV-2). It has a strong transmission capacity and can cause severe and even fatal respiratory diseases. It can also affect other organs such as the heart, kidneys and digestive tract. Clinical evidence indicates that kidney injury is a common complication of COVID-19, and acute kidney injury (AKI) may even occur in severely ill patients. Data from China and the United States showed that male sex, Black race, the elderly, chronic kidney disease, diabetes, hypertension, cardiovascular disease, and higher body mass index are associated with COVID-19‐induced AKI. In this review, we found gender and ethnic differences in the occurrence and development of AKI in patients with COVID-19 through literature search and analysis. By summarizing the mechanism of gender and ethnic differences in AKI among patients with COVID-19, we found that male and Black race have more progress to COVID-19-induced AKI than their counterparts.
... Further, probing the comorbidities associated with pre and post SARS-CoV-2 infection is a comprehensive approach to reveal the biological phenomenon causing varying disease severity levels across COVID-19 patients. Accordingly, many meta-analyses identified that individuals with pre-existing disease conditions such as cancer [8], cerebrovascular disease [9], type 2 diabetes mellitus [10], chronic obstructive pulmonary disease (COPD) [11,12], hypertension [12,13], and chronic kidney disease [14,15] are more susceptible to COVID-19 infection. Likewise, a few post-SARS-CoV-2 clearance follow-up studies (3À6 months) have reported chronic fatigue, mental illness, breathlessness and insomnia being the most common disorders observed in the discharged patients [16,17]. ...
Background
Consecutive negative SARS-CoV-2 PCR test results are being considered to estimate viral clearance in COVID-19 patients. However, there are anecdotal reports of hospitalization from protracted COVID-19 complications despite such confirmed viral clearance, presenting a clinical conundrum.
Methods
We conducted a retrospective analysis of 222 hospitalized COVID-19 patients to compare those that were readmitted post-viral clearance (hospitalized post-clearance cohort, n = 49) with those that were not re-admitted post-viral clearance (non-hospitalized post-clearance cohort, n = 173) between February and October 2020. In order to differentiate these two cohorts, we used neural network models for the ‘augmented curation’ of comorbidities and complications with positive sentiment in the Electronic Hosptial Records physician notes.
Findings
In the year preceding COVID-19 onset, anemia (n = 13 [26.5%], p-value: 0.007), cardiac arrhythmias (n = 14 [28.6%], p-value: 0.015), and acute kidney injury (n = 7 [14.3%], p-value: 0.030) were significantly enriched in the physician notes of the hospitalized post-clearance cohort.
Interpretation
Overall, this retrospective study highlights specific pre-existing conditions that are associated with higher hospitalization rates in COVID-19 patients despite viral clearance and motivates follow-up prospective research into the associated risk factors.
Funding
This work was supported by Nference, inc.
Globally, the coronavirus disease 2019 (COVID-19) pandemic has adversely affected healthcare with significant morbidity and mortality among patients due to the virulent effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The kidneys and other organs are infected and the development of renal disorders such as acute kidney injury (AKI) and subsequently chronic renal disease if there is no clinical intervention. There is increasing evidence of more COVID-19 patients developing AKI, and incidence of mild, moderate and severe stages of the disease. There is also evidence of significant morbidity and mortality, especially in patients with severe AKI admitted to the intensive care units (ICU). We reviewed the recent publications in PubMed, Google Scholar, Embase and Cochrane library relating to AKI in COVID-19 patients. This review examines (i) multifactorial causes of AKI in COVID-19 and the pathophysiology of this renal disorder, (ii) incidence of AKI in COVID-19 as well as the same in mild, moderate and severe disease, (iii) the association between the incidence of AKI and disease severity as well as mortality in patients with confirmed COVID-19, and (iv) incidence of renal replacement therapy among COVID-19 patients with AKI. The evidence points to the need for early therapeutic intervention and multidisciplinary supportive care for COVID-19 patients. This is critical for COVID-19 patients with comorbidities such as diabetes mellitus, hypertension and cardiovascular diseases as their renal function may be compromised.
Introduction
Acute Kidney Injury has been associated with a higher mortality rate among hospitalized patients with Coronavirus disease.The present review aimed to evaluate the association of COVID-19 with acute kidney injury. The study also aimed to assess the symptoms, complications, and treatment performed for the successful management of acute kidney injury patients with COVID-19.
Methodology
The literature review search was conducted by using PubMed, Medline, and another database of medical journals for identifying, reviewing, and evaluating the published articles with cases of COVID-19 and acute kidney injury complications.
Results
The systematic review of 25 studies found that patients with COVID-19 had a high prevalence of acute kidney injury due to risk factors, such as hypertension, diabetes, cardiovascular disease, and the overuse of diuretics. The average age of acute kidney injury occurrence in patients was from 54-70 years of age. From 25 studies, a total of 27922 patients, 29.9%, were detected with acute kidney injury with the pathological cause of acute tubular necrosis and focal segmental glomerulosclerosis.
Conclusion
The current systematic review indicates a high prevalence of acute kidney injury among COVID-19 patients with hospitalisation. Patients with COVID-19 pose a risk for the development of acute kidney injury due to chronic infection, high use of corticosteroids, and systemic hemodynamic instability, which results in acute tubular injury in hospitalised COVID-19 patients.
A majority of the patients were seen with undiagnosed acute kidney injury. Early detection in such comorbid cases can resolve renal complications and improve the therapeutic outcome in COVID-19 patients.
