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Meta-Analysis
. 2021 Aug;53(8):1623-1629.
doi: 10.1007/s11255-020-02740-3. Epub 2021 Jan 3.

Mortality in chronic kidney disease patients with COVID-19: a systematic review and meta-analysis

Ruyi Cai  1   2   3   4 , Jinshi Zhang  1   2   3   4 , Yifan Zhu  2   3   4 , Lin Liu  2   3   4 , Yueming Liu  2   3   4 , Qiang He  5   6   7
Affiliations
Meta-Analysis

Mortality in chronic kidney disease patients with COVID-19: a systematic review and meta-analysis

Ruyi Cai et al. Int Urol Nephrol. 2021 Aug.

Abstract

At the beginning of 2020, the outbreak of coronavirus disease 2019 (COVID-19) led to a worldwide pandemic and mass panic. The number of infected people has been increasing exponentially since, and the mortality rate has also been concomitantly increasing. At present, no study has summarized the mortality risk of COVID-19 in patients with chronic kidney disease (CKD). Therefore, the aim of the present study was to conduct a literature review and meta-analysis to understand the frequency of mortality among CKD patients infected with COVID-19. A comprehensive systematic search was conducted on the PubMed, Embase, and Cochrane databases to find articles published until May 15, 2020. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. After careful screening based on the inclusion and exclusion criteria, 3,867,367 patients from 12 studies were included. The mortality rate was significantly higher among CKD patients with COVID-19 infection than among CKD patients without COVID-19 infection, as indicated by a pooled OR of 5.81 (95% CI 3.78-8.94, P < 0.00001, I2 = 30%). The patients were then stratified into ≥ 70 and < 70 years, and subgroup analysis revealed that among CKD patients with COVID-19 infection, the mortality rate was higher in the < 70 years group (OR 8.69, 95% CI 7.56-9.97, P < 0.0001) than in the ≥ 70 years group (OR 2.44, 95% CI 0.75-6.63, P = 0.15). Thus, COVID-19 patients with CKD have a high mortality risk and require a comprehensive multidisciplinary management strategy.

Keywords: COVID-19; Chronic kidney disease; Mortality; SARS-CoV-2.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Figures

Fig. 1
Fig. 1
Flow chart depicting the search strategy to identify articles on the relationship between CKD and the mortality of patients with COVID-19
Fig. 2
Fig. 2
Forest plot depicting the relationship between CKD and the mortality of patients with COVID-19
Fig. 3
Fig. 3
Forest plot depicting the relationship between CKD and the mortality of COVID-19 patients after subgroup analysis according to age
Fig. 4
Fig. 4
Funnel plot depicting publication bias
See this image and copyright information in PMC

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