Nutritional Advice El Mondo
Objectives:
Are acute kidney injury, acute liver injury and coagulopathy associated with poor composite outcome in patients with COVID-19?
Study design:
This review article included 15 studies with 3,615 COVID-19 patients.
The mean Newcastle-Ottawa scale of the included studies was 7.3 ± 1.2.
Five studies did not report baseline serum creatinine levels. Nevertheless, the exclusion of the aforementioned studies in the sensitivity analysis showed a consistent conclusion.
The heterogeneity of acute liver injury and coagulopathy was probably caused by the varying definitions used in the studies, which were not reported.
Results and conclusions:
The investigators found acute kidney injury was associated with an increased composite outcome of 955% [RR = 10.55, 95% CI = 7.68 to 14.50, p 0.001, I2 = 0%].
The investigators found subgroup analysis showed that acute kidney injury was associated with over thirteenfold enhanced risk of COVID-19 mortality [RR = 13.38, 95% CI = 8.15 to 21.95, p 0.001, I2 = 24%].
The investigators found subgroup analysis showed that acute kidney injury was associated with over eightfold enhanced risk of severe COVID-19 [RR = 8.12, 95% CI = 4.43 to 14.86, p 0.001, I2 = 0%].
The investigators found subgroup analysis showed that acute kidney injury was associated with over fivefold enhanced risk for the need for ICU care [RR = 5.90, 95% CI = 1.32 to 26.35, p = 0.02, I2 = 0%].
The investigators found subgroup analysis showed that acute liver injury was associated with over fourfold enhanced risk of COVID-19 mortality [RR = 4.02, 95% CI = 1.51 to 10.68, p = 0.005; I2 = 88%].
The investigators found meta-regression showed acute kidney injury was associated with the composite outcome and was not influenced by age [p = 0.182], sex [p = 0.104], hypertension [p = 0.788], cardiovascular diseases [p = 0.068], diabetes [p = 0.097], respiratory comorbidity [p = 0.762] and chronic kidney disease [p = 0.77].
The investigators concluded acute kidney injury is associated with poor composite outcomes, including mortality, severe COVID-19 and the need for ICU care in COVID-19 patients. This association is not significantly influenced by gender, age, cardiovascular disease, diabetes, chronic obstructive pulmonary disease and chronic kidney disease. Moreover, acute liver injury and coagulopathy are also associated with increased mortality in patients with COVID-19. Due to the high risk of bias and poor comparability of the included studies, the effect estimate may not reflect the magnitude of the true effect.
Original title:
Multiorgan Failure With Emphasis on Acute Kidney Injury and Severity of COVID-19: Systematic Review and Meta-Analysis by Lim MA, Pranata R, […], Supriyadi R.
Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7343353/
Additional information of El Mondo:
Find more information/studies on coronavirus right here.