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Research article
Junzhe Chen
Sun Yat-Sen University
Corresponding Author
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Background: Acute kidney injury (AKI) occurs among patients with COVID-19, it is also proved to be associated with in-hospital mortality. Remdesivir, an RNA polymerase inhibitor, has shown its antiviral activity in vitro and animal models. The adverse effect of Remdesivir especially AKI is the most common cause which lead to drug discontinuation. Whether Remdesivir increases the risk of AKI in patients with COVID-19 is not clear. We conducted a systematic review and meta-analysis to evaluate the incidence rate of AKI in hospitalized COVID-19 patients and whether Remdesivir increases the risk of AKI.
Methods: A thorough search was carried out to find relevant studies in PubMed, medRxiv, and Web of Science from 1 Jan 2020 till 1 June 2020. 15135 COVID-19 patients and 981 COVID-19 patients using Remdesivir were included in our meta-analysis.
Results: The pooled estimated incidence of AKI in all hospitalized COVID-19 patients was 12.0% (95% CI:9.0%-15.0%). According to our subgroup study, the incidence of AKI was associated with the age, disease severity and race of patients. The incidence of AKI in hospitalized COVID-19 patients using Remdesivir was 6% (95% CI: 3%-13%) with a total of 5 studies. Comparing with COVID-19 patients without Remdesivir treatment, Remdesivir treatment do not increase the risk of AKI in COVID-19 patients showing OR 0.80(95%CI: 0.44-1.46, P>0.05).
Conclusions: We found out that AKI was not rare in hospitalized COVID-19 patients. The incidence of AKI was associated with age, disease severity and race. Remdesivir treatment did not increase the risk of AKI in hospitalized COVID-19 patients. Our meta-analysis may provide an evidence for future study that AKI is associated with the natural cause of COVID-19, not the adverse event after the usage of Remdesivir.
Keywords
COVID-19, SARS-CoV-2, acute kidney injury (AKI), Remdesivir
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View the published article at BMC Nephrology.
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Editorial decision: Accept
On 14 Jan, 2021
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On 13 Jan, 2021
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Editorial decision: Minor revision
On 06 Jan, 2021
Review #2 received
Received 31 Dec, 2020
Reviewer #3 agreed
On 22 Dec, 2020
Review #1 received
Received 22 Dec, 2020
Reviewer #2 agreed
On 19 Dec, 2020
Reviewers invited
Invitations sent on 19 Dec, 2020
Reviewer #1 agreed
On 19 Dec, 2020
Editor assigned
On 07 Dec, 2020
Submission checks complete
On 07 Dec, 2020
Editor invited
On 07 Dec, 2020
Version 1
Posted 02 Sep, 2020
No comments provided
Editorial decision: Major revision
On 03 Nov, 2020
Review #1 received
Received 29 Oct, 2020
Review #4 received
Received 25 Oct, 2020
Review #3 received
Received 24 Oct, 2020
Reviewer #4 agreed
On 16 Oct, 2020
Review #2 received
Received 16 Oct, 2020
Reviewer #3 agreed
On 12 Oct, 2020
Reviewer #2 agreed
On 09 Oct, 2020
Reviewers invited
Invitations sent on 08 Oct, 2020
Reviewer #1 agreed
On 08 Oct, 2020
Editor assigned
On 20 Aug, 2020
Submission checks complete
On 19 Aug, 2020
Editor invited
On 19 Aug, 2020
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On 18 Aug, 2020
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Subject Areas
Urology & Nephrology
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See the published version of this preprint at BMC Nephrology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Junzhe Chen
Sun Yat-Sen University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Nephrology.
No community comments so far
Editorial decision: Accept
On 14 Jan, 2021
Submission checks complete
On 13 Jan, 2021
No comments provided
Editorial decision: Minor revision
On 06 Jan, 2021
Review #2 received
Received 31 Dec, 2020
Reviewer #3 agreed
On 22 Dec, 2020
Review #1 received
Received 22 Dec, 2020
Reviewer #2 agreed
On 19 Dec, 2020
Reviewers invited
Invitations sent on 19 Dec, 2020
Reviewer #1 agreed
On 19 Dec, 2020
Editor assigned
On 07 Dec, 2020
Submission checks complete
On 07 Dec, 2020
Editor invited
On 07 Dec, 2020
Version 1
Posted 02 Sep, 2020
No comments provided
Editorial decision: Major revision
On 03 Nov, 2020
Review #1 received
Received 29 Oct, 2020
Review #4 received
Received 25 Oct, 2020
Review #3 received
Received 24 Oct, 2020
Reviewer #4 agreed
On 16 Oct, 2020
Review #2 received
Received 16 Oct, 2020
Reviewer #3 agreed
On 12 Oct, 2020
Reviewer #2 agreed
On 09 Oct, 2020
Reviewers invited
Invitations sent on 08 Oct, 2020
Reviewer #1 agreed
On 08 Oct, 2020
Editor assigned
On 20 Aug, 2020
Submission checks complete
On 19 Aug, 2020
Editor invited
On 19 Aug, 2020
First submitted
On 18 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Urology & Nephrology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Nephrology.
Background: Acute kidney injury (AKI) occurs among patients with COVID-19, it is also proved to be associated with in-hospital mortality. Remdesivir, an RNA polymerase inhibitor, has shown its antiviral activity in vitro and animal models. The adverse effect of Remdesivir especially AKI is the most common cause which lead to drug discontinuation. Whether Remdesivir increases the risk of AKI in patients with COVID-19 is not clear. We conducted a systematic review and meta-analysis to evaluate the incidence rate of AKI in hospitalized COVID-19 patients and whether Remdesivir increases the risk of AKI.
Methods: A thorough search was carried out to find relevant studies in PubMed, medRxiv, and Web of Science from 1 Jan 2020 till 1 June 2020. 15135 COVID-19 patients and 981 COVID-19 patients using Remdesivir were included in our meta-analysis.
Results: The pooled estimated incidence of AKI in all hospitalized COVID-19 patients was 12.0% (95% CI:9.0%-15.0%). According to our subgroup study, the incidence of AKI was associated with the age, disease severity and race of patients. The incidence of AKI in hospitalized COVID-19 patients using Remdesivir was 6% (95% CI: 3%-13%) with a total of 5 studies. Comparing with COVID-19 patients without Remdesivir treatment, Remdesivir treatment do not increase the risk of AKI in COVID-19 patients showing OR 0.80(95%CI: 0.44-1.46, P>0.05).
Conclusions: We found out that AKI was not rare in hospitalized COVID-19 patients. The incidence of AKI was associated with age, disease severity and race. Remdesivir treatment did not increase the risk of AKI in hospitalized COVID-19 patients. Our meta-analysis may provide an evidence for future study that AKI is associated with the natural cause of COVID-19, not the adverse event after the usage of Remdesivir.
Figure 1
Figure 2
Figure 3
Figure 4
This is a list of supplementary files associated with this preprint. Click to download.
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