Table 1 Studies with demographics and outcomes in patients with COVID-19

Study

N (setting)

Female (%)

Median age, years

History of CKD, n (%)

History of CVD, n (%)

Incidence of AKI, n (%)

RRT, n (%)

Mechanical Ventilation, n (%)

Mortality, n (%)

Salient Findings

Yang [15] ^a

52 (I)

33

52

NR

5 (10%)

15 (29%)

9 (17%)

37 (71%)

32 (61.5%)

–

Wu [17]

80 (G + I)

51.2

46.1

1 (1.2%)

25 (31.3%)

2 (2.5%)

1 (1.2%)

0

0

–

Xia ^a

81 (G + I)

33

67

3 (3.7%)

28 (35%)

41 (50%)

Stage 1: 27%

Stage 2: 31%

Stage 3: 42%

8 (10%)

66 (80%)

60 (75%)

The primary pathological findings were those of acute tubular injury.

Nucleic acid tests and immunohistochemistry failed to detect the virus in kidney tissues. Older age and serum IL-6 levels were risk factors of AKI. KDIGO stage 3 AKI independently predicted death.

Diao [18]

85 (G + I)

43.5

NR

5 (6%)

19 (22.3%)

23 (27%)

NR

NR

NR

AKI likely in elderly patients with comorbidities (HTN, CVD).

Chen [19]

99 (G + I)

32.3

55.5

NR

40 (40%)

3 (3%)

9 (9%)

13 (13%)

11 (11%)

–

Wang [14]

^a

138 (G + I)

45.7

56

4 (2.9%)

27 (19.5%)

5 (3.6%)

2 (1.5%)

17 (12.3%)

6 (4.3%)

26% required ICU treatment.

Zhou [12] ^a

191 (G + I)

38

56

2 (1%)

15 (8%)

28 (15%)

10 (5%)

32 (17%)

54 (28.2%)

Non-survivors were likely to be elderly, have comorbidities (CVD, HTN, CKD), or

elevated creatinine.

Cao [20]

198 (G + I)

49

50.1

NR

12 (6%)

10 (5.3%)

NR

NR

NR

ICU admissions were more likely to have elevated BUN/creatinine, hyponatremia, CVD.

Zhang [21] ^a

221 (G + I)

51

55

6 (2.7%)

37 (17%)

10 (4.5%)

5 (2.3%)

26 (12%)

12 (5.4%)

Older patients had higher risk of AKI, ARDS and acute cardiac dysfunction.

Patients with severe CoVID likely to have higher BUN/creatinine.

Xiao [16] ^a

287 (G + I)

44.3

62

5 (2%)

33 (12%)

55 (19%)

AKI stage 1: 14.3%

AKI stage 2&3: 4.9%

NR

NR

19 (6.6%)

Patients with AKI likely to be older, with HTN, cerebrovascular disease, and likely to present with hypoxia. Patients with AKI also had higher levels of WBC counts, total bilirubin, CK and AST. AKI associated with lower discharge rates and higher mortality.

Pei [22]^a

333(G + I)

45.3

56.3

NR

NR

35 (10.5%)

6 (0.1%)

NR

29 (8.3%)

Logistic regression analyses showed that severity of pneumonia was associated with lower odds of proteinuric or hematuric remission and recovery from AKI.

Cheng [13] ^a

701 (G + I)

47.6

63

14 (2%)

NR

36 (5.1%)

NR

97 (13.4%)

113 (16.4%)

Elevated baseline serum creatinine, elevated baseline blood urea nitrogen, AKI stage 1/2/3, proteinuria 1+/2+/3+, and hematuria 1+ were independent risk factors for death.

Guan [7] ^a

1099 (G + I)

41.9

47

8 (0.7%)

42 (4%)

6 (0.5%)

9 (0.8%)

25 (2.3%)

15 (1.4%)

–

Study

N (setting)

Female (%)

Median age, years

History of CKD, n (%)

History of CVD, n (%)

Incidence of AKI, n (%)

RRT, n (%)

Mechanical Ventilation, n (%)

Mortality, n (%)

Salient Findings

ICNARC [6]^a

6143 (I)

28.7%

60

126 (1.6%)

32 (0.4%)

NR

1442 (23.4%)

4287 (70%)

2872 (46.8%)

71% patients on RRT died in ICU.

Rubin [24]^a

71 (I)

23%

61.2

4 (6%)

21 (30%)

57 (80%)

Stage 1: 28%

Stage 2: 28%

Stage 3: 24%

10 (14%)

55 (71%)

4 (5.6%)

At day 21, 64% of patients had recovered from AKI, and 11% were RRT dependent.

Portolés [25]

1603 (G + I)

40

64

144 (9%)

561 (35%)

336 (21%)

17 (1%)

NR

197 (12.3%)

A prospective cohort study showing in-hospital AKI associated with high mortality

ISARIC [26]

20,133 (I)

40.1%

72.9

2830 (16.2%)

5469 (31%)

NR

NR

618 (37%)

NR

Higher proportion of patients had CKD, with a multivariate HR of 1.28 for death.

Study

N (setting)

Female (%)

Median age, years

History of CKD, n (%)

History of CVD, n (%)

AKI Incidence, n (%)

RRT, n (%)

Mechanical Ventilation, n (%)

Mortality, n (%)

Salient Findings

Arentz [27] ^a

21 (I)

48

70

10 (47.6%)

9 (42.9%)

4 (19%)

NR

15 (71%)

11 (52.4%)

2 patients with ESKD.

Mohamed [9] ^a

575 (G + I)

38

65

162 (28%)

178 (31%)

161 (30%)

89 (15.4%)

155 (27%)

NR

Higher BMI and inflammatory markers were associated with AKI and RRT requirement.

Cummings [28]

257 (I)

33

62

37 (14%)

49 (19%)

NR

79 (31%)

203 (79%)

101 (39%)

CKD had a univariate HR of 1.5 for in-hospital mortality

Argenziano [29]

1000 (G + I)

40

63

137 (13.7%)

233 (23.3%)

288 (28.8%)

117 (11.7%)

233 (23.3%)

211 (21.1%)

78.0% of patients in ICU developed AKI; 35.2% of patients in intensive care units required RRT

Gupta [30]

2151 (I)

35.2

60.5

280 (12.6%)

484 (22%)

921 (43%)

432 (20%)

1494 (67.4)

784 (35%)

A score of 4 on renal component of SOFA score was associated with OR of 2.5 for 28 day mortality

Chan [7] ^a

3235 (G + I)

42.3

66.5

323 (10%)

461 (17.4%)

1404 (46%)

Stage 1: 16%

Stage 2: 9%

Stage 3: 21%

280 (20%)

NR

NR

Patients with AKI were older and more likely to have HTN, CHF, DM, and CKD.

Independent predictors of AKI included CKD, systolic BP and potassium at baseline.

Mortality of patients with AKI was 41% overall, and 52% in ICU.

Adjusted OR for death was 20.9 for ICU-AKI vs no AKI.

Fisher [11] ^a

3345 (G + I)

47

65

409 (12%)

1904 (57%)

Stage 1: 50%

Stage 2: 20%

Stage 3:30%

164 (5%)

624 (18%)

775 (23%)

Compared with patients without COVID-19 and with historical controls, patients with COVID-19 had a significantly higher incidence of AKI and were more likely to require RRT

Hirsch [10] ^ba

5449(G + I)

39

64

NR

949 (17.4%)

1993 (36.6%)

285 (5.2%)

1190 (21.8%)

888 (16.3%)

89.7% of patients on mechanical ventilation developed AKI compared to 21.7% of non-ventilated patients.

Richardson [31]

^ba

5700 (G + I)

39.7

63

268 (5%)

966 (18%)

523 (22.2%)

81 (3.2%)

320 (12.2%)

553 (21%)

186 patients (3.5%) with ESKD included.