The systemic review of subgroup analysis on the incidence of acute kidney injury(AKI) in patients with COVID-19

Abstract Background: Acute kidney injury (AKI) occurs among patients with Coronavirus disease-19 (COVID-19) and has also been proven to be associated with in-hospital mortality. Remdesivir has been authorized for the treatment of COVID-19 patients. We conducted a systematic review to evaluate the incidence of AKI in hospitalized COVID-19 patients. The incidence of AKI in different subgroups was also investigated. Method: A thorough search was carried out to find relevant studies in PubMed, Web of Science, medRxiv and EMBASE from 1 Jan 2020 until 1 June 2020. All systemic reviews of proportions were performed using the meta package for R project (4.0.1).Results: A total of 16199 COVID-19 patients were included in our systematic review. The pooled estimated incidence of AKI in all hospitalized COVID-19 patients was 10.0% (95% CI: 7.0-12.0%). The pooled estimated need for continuous renal replacement therapy (CRRT) in COVID-19 patients was 4% (95% CI: 3-6%). According to our subgroup analysis, the incidence of AKI could be associated with the age, disease severity and the ethnicity of the patients. The incidence of AKI in hospitalized COVID-19 patients being treated with remdesivir was 7% (95% CI: 3-13%) in a total of 5 studies.Conclusion: We found that AKI was not rare in hospitalized COVID-19 patients. The incidence of AKI could be associated with age, disease severity and ethnicity. Remdesivir probably not induced AKI in COVID-19 patients. Our systemic review provides evidence for future studies that AKI might be closely associated with SARS-CoV-2 infection.