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Review
. 2020 May 15;5(2):80.
doi: 10.3390/tropicalmed5020080.

Prognosis of COVID-19 in Patients with Liver and Kidney Diseases: An Early Systematic Review and Meta-Analysis

Tope Oyelade  1 , Jaber Alqahtani  2 , Gabriele Canciani  1   3
Affiliations
Review

Prognosis of COVID-19 in Patients with Liver and Kidney Diseases: An Early Systematic Review and Meta-Analysis

Tope Oyelade et al. Trop Med Infect Dis. .

Abstract

The mortality and severity in COVID-19 is increased in patients with comorbidities. The aim of this study was to evaluate the severity and mortality in COVID-19 patients with underlying kidney and liver diseases. We retrieved data on the clinical features and primary composite end point of COVID-19 patients from Medline and Embase which had been released from inception by the April 16, 2020. The data on two comorbidities, liver diseases and chronic kidney disease, were pooled and statistically analysed to explain the associated severity and mortality rate. One hundred and forty-two abstracts were screened, and 41 full articles were then read. In total, 22 studies including 5595 COVID-19 patients were included in this study with case fatality rate of 16%. The prevalence of liver diseases and chronic kidney disease (CKD) were 3% (95% CI; 2-3%) and 1% (95% CI; 1-2%), respectively. In patients with COVID-19 and underlying liver diseases, 57.33% (43/75) of cases were severe, with 17.65% mortality, while in CKD patients, 83.93% (47/56) of cases were severe and 53.33% (8/15) mortality was reported. This study found an increased risk of severity and mortality in COVID-19 patients with liver diseases or CKD. This will lead to better clinical management and inform the process of implementing more stringent preventative measures for this group of patients.

Keywords: COVID-19; SARS-CoV-2; alcohol-related liver disease; chronic kidney disease; cirrhosis; hepatitis B and C; necrosis; nonalcoholic steatohepatitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Medline Search Strategy.
Figure A2
Figure A2
Embase Search Strategy.
Figure 1
Figure 1
Risk of COVID-19 in patients with chronic liver and kidney diseases: a systematic review according to the Preferred Reporting Items for Systematic Reviews and Metanalyses diagram.
Figure 2
Figure 2
Pooled prevalence of patients with chronic renal diseases diagnosed with COVID-19. The red dotted line represents the overall effect size of the studies (0.01). The lateral edges of the blue diamond represent the limits of the 95% confidence intervals (0.01, 0.02). ES = Effect Size, NOS = Newcastle-Ottawa Score.
Figure 3
Figure 3
Pooled prevalence of patients with liver diseases (Chronic Liver Diseases, Hepatitis B/C infections) diagnosed with COVID-19. The red dotted line represents the overall effect size of the studies (0.03). The edges of the blue diamond represent 95% confidence intervals (0.02, 0.03). ES = Effect Size, NOS = Newcastle-Ottawa Score.
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