Connecting the dots: A systematic exploration of coronavirus disease 2019 and acute kidney injury through meta-analysis

The coronavirus disease 2019 (COVID-19) pandemic has posed a global threat, yet our understanding of acute kidney injury (AKI) in COVID-19 patients remains incomplete, with studies reporting conflicting data on its prevalence. This meta-analysis aims to clarify the progression of AKI and the associated mortality risk in this patient population through a systematic review of the literature up to June 8, 2023. Studies included in this analysis report clinical characteristics, AKI incidence, and mortality risk. Analysis of five studies identified older age (73 – 75) and male gender (67 – 84.2%) as significant risk factors for severe illness. COVID-19 patients who developed AKI had over five times the mortality risk compared to those without AKI. The median time from disease onset to diagnosis was 8.5 days (interquartile range [IQR]: 4 – 11), with a median fatality time of 13.5 days (IQR: 8 – 17) post-admission among non-survivors. Systemic inflammation, acute myocardial injury, and acute respiratory distress syndrome were prevalent among non-survivors, along with significant abnormalities in biochemical and immunological markers. This analysis underscores the importance of early intervention and highlights the dynamic changes in biochemical and immunological markers as the disease progresses, suggesting a need for further research to understand the mechanisms underlying AKI in COVID-19 patients.