Lesión renal aguda en el síndrome inflamatorio multisistémico pediátrico asociado a COVID-19 (SIM-C) durante 2020-2022: una revisión sistemática.

Abstract

Objective: Estimate the frequency of acute kidney injury in patients with pediatric multisystem inflammatory syndrome associated with COVID-19 (MIS-C) during 2020-2022. Materials and Methods: Systematic Review. The search was conducted in Medline, Scopus, Embase, Cochrane, Web of Science, and Scielo, as well as in “preprint” repositories, up to December 15, 2022. Study selection, data extraction, and risk of bias assessment were performed in duplicate and independently. Patients with MIS-C who developed acute kidney injury during their hospitalization were included. We performed a random-effects model proportion meta-analysis, explored sources of heterogeneity, and assessed the certainty of the evidence using the GRADE methodology. Results: Nineteen studies were included (from 2020 to 2022). A total of 1,379 patients developed acute kidney injury out of 8,221 patients with MIS-C. The pooled frequency of acute kidney injury was 15.96% (95% CI: 11.33–21.18; I2=92%), with very low certainty of the evidence. Having a higher frequency of acute kidney injury was not associated with increased mortality (p=0.99). A higher frequency of acute kidney injury was observed in patients admitted to intensive care or in females (p<0.05). Additionally, we found that the presence of any comorbidity had a marginally significant association (p=0.09) with a higher frequency of acute kidney injury. Conclusions: The frequency of acute kidney injury was high in patients hospitalized with MIS-C. It is necessary to explore other sources of heterogeneity based on well-designed methodological cohorts.