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Global Translational Medicine COVID-19 and acute kidney injury

3.4. Meta-analysis findings
RRT (n) CRRT (5) CRRT (7) N/A CRRT (4) CRRT (7) Our meta-analysis revealed significant associations
Abbreviations: AKI: Acute kidney injury; AKIN: Acute Kidney Injury Network; BUN: Blood urea nitrogen; CRRT: Continuous renal replacement therapy; eGFR: Estimated glomerular filtration
between COVID-19 and AKI, particularly in relation to
rate; HR: Hazard ratio; KDIGO: Kidney Disease: Improving Global Outcomes; n: Number of patients received RRT; N/A: Not available; OR: Odd ratio; RRT: Renal replacement therapy.
D‑dimer 16/30 18/155 512/661 107 128/182 mortality and various clinical parameters.
3.4.1. High mortality in older male patients
eGFR 30/30 N/A 701/701 N/A N/A The pooled analysis demonstrates a consistent association
between older age, male sex, and increased mortality
5-7
Hematuria N/A N/A 118/442 N/A 71/147 among COVID-19 patients with AKI. Specifically, a
study from the United States (US) Department of Veterans
Affairs highlights that AKI was associated with a higher
60-day mortality risk for all COVID-19 patients (HR:
Proteinuria N/A N/A 194/442 N/A 88/147 4.35; CI: 4.23 – 4.50) and hospitalized patients (HR: 2.29;
CI: 2.19 – 2.40). The main predictors of 60-day mortality
among AKI patients included the use of vasopressors (HR:

BUN 30/160 18/155 701 N/A 59/193 4.32; CI: 4.13 – 4.53), age over 65 (HR: 2.11; CI: 1.98 –
2.25), and male gender (HR: 1.34; CI: 1.17 – 1.53).
Baseline creatinine 30/30 18/155 36/36 107 43/193 3.4.2. In-hospital mortality in AKI patients
A large nationwide study conducted among US veterans
examined the mortality rates of COVID-19-positive
AKI 30 7 36 14 55 patients who developed AKI. The study found that
8
COVID-19 patients with AKI had significantly elevated
AKI‑related death mortality risks compared to those without AKI. Specifically,
Table 3. Characteristics of studies included in the systematic review (Quantitative analysis)
the mortality rate among AKI patients was approximately
HR
HR
5.3 times higher than that of hospitalized non-AKI
OR
17
7
patients. This elevated mortality risk was attributed to
AKI definition AKIN N/A KDIGO KDIGO KDIGO age, and male gender.
various factors, including the use of vasopressors, older
3.4.3. The interval between disease onset and
Study population 164 155 701 107 193 diagnosis
Two studies highlight the importance of understanding
the incubation period of COVID-19 and the duration
from illness onset to hospital admission, both of which
are crucial for disease progression and public health
Date of publication June 3, 2020 May 22, 2020 March 16, 2020 April 30, 2020 2020 measures. The incubation period is the time between the
2,7
initial exposure to the virus and the onset of symptoms.
Understanding the length of this period is vital for making
informed decisions about quarantine durations, assessing
viral transmissibility, estimating the pandemic’s scale, and
implementing effective control measures.
9
The World Health Organization and the European

an incubation period of 0 – 14 days, based on the limited
Journal J. Clin. Med Front. Med Kidney International Critical Care MedRxiv Centre for Disease Prevention and Control have suggested
data available to definitively determine the exact incubation
period. This range is similar to that of the MERS and SARS
coronaviruses. 9
Furthermore, the average incubation period for
Study Lim et al. 5 Shao et al. 6 Cheng et al. 2 Wang et al. 7 Li et al. 8 COVID-19 across all variants is approximately 6 days,
although it can vary depending on the strain. The

Volume 3 Issue 3 (2024) 5 doi: 10.36922/gtm.2798