Acute kidney injury and its association with mortality in Asian COVID-19 patients: A meta-analysis

Background: Previous evi-dence suggests that acute kidney injury (AKI) is common in patients with COVID-19 and associated with adverse outcomes. Moreover, the incidence and mortality of AKI in Asia are ambiguous. Objective: Evalu-ating the risk factors and risk of death from AKI in COVID-19 patients in Asia. Materi-als and methods: We conducted a meta -analysis of clinical observational studies of COVID-19 patients in Asia. Outcome mea-sures included: AKI in COVID-19 patients, overall mortality in COVID-19 patients, and mortality assessment in patients with AKI. The random-effects model was adopted, with heterogeneity and sensitivity analysis. Results: 27 clinical studies (18,216 Asian pa-tients with COVID-19) have been included in the study. The pooled incidence of AKI was 0.19 (95% CI 16 - 23%; I2 = 98.9%, p < 0.001); the pooled incidence of total mortality was 0.19 (95% CI 17 - 22%; I2 = 98.9%, p < 0.001). No publication bias was found (Egger's test, p = 0.396, 0.213). The pooled mortality in AKI patients with COVID-19 was 50% (95% CI 33 - 67%; I2 by random-effects model = 98.4%, p < 0.001). AKI was found to be a risk factor for death in stepwise regres-sion analysis; age, diabetes, and hyperten-sion were influencing factors for AKI risk in COVID-19 patients. Conclusion: AKI is a com-mon complication in Asian COVID-19 pa-tients, and it is associated with an increase in mortality of Asian COVID-19 patients. Any treatment that protects the kidney may be a practical intervention to reduce the mortal-ity of COVID-19 patients in Asia.