Coronavirus Disease 2019: Coronaviruses and Kidney Injury

Lv, Wenchang; Wu, Min; Ren, Yuping; Zeng, Ning; Deng, Pei; Zeng, Hong; Zhang, Qi; Wu, Yiping

doi:10.1097/ju.0000000000001289

Cited by 16 publications

(16 citation statements)

References 48 publications

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“…Presence of renal complications in COVID-19 disease is associated with higher rate of diverse outcome including mortality [22]. Previous reports of COVID-19 patients documented that hematuria, proteinuria and AKI are associated with high incidence of ICU admission, acute kidney injury and mortality [17][18][19][20]25].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, AKI has now become an alarming sign and a significant risk factor for mortality in hospitalized COVID-19 patients [7,23,24]. The prevalence of AKI among SARS-CoV-2 infected patients from different countries is variable [25]. Previous studies reported an incidence of AKI among COVID-19 patients ranging from 5 to 29% [8,24,[26][27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

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Manifestations of renal system involvement in hospitalized patients with COVID-19 in Saudi Arabia

et al. 2021

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Background Although COVID-19 is an acute disease that usually resolves rapidly in most cases, the disease can be fatal and has a mortality rate of about 1% to 56%. Alveolar injury and respiratory failure are the main causes of death in patients with COVID 19. In addition, the effect of the disease on other organs is not fully understood. Renal system affection has been reported in patients with COVID 19 and is associated with a higher rate of diverse outcomes, including mortality. Therefore, in the present work, we reported the clinical characteristics and laboratory data of hospitalized patients with COVID-19 and analyzed the manifestations that indicated renal system involvement and their impact on clinical outcomes. Materials and methods This was an observational retrospective study conducted at King Fahd Specialist Hospital, Buraydah, Saudi Arabia. All patients with COVID-19 who were admitted to this Hospital from April to December 2020 were included in the study. The patients’ findings at presentation were recorded. Demographic data and laboratory results (hematuria, proteinuria, urinary sediment cast and pus cell presence, and kidney function tests) were retrieved from electronic patient records. Results One hundred and ninety-three patients with confirmed COVID 19 were included in the study. Dipstick examinations of all urine samples showed proteinuria and hematuria in 53.9% and 22.3% of patients, respectively, whereas microscopic examination revealed the presence of pus and brown muddy granular casts in 33.7% and 12.4% of samples, respectively. Acute kidney injury was reported in 23.3% of patients. A multivariable analysis demonstrated that hematuria was associated with acute kidney injury (AKI) (OR, 2.4; 95% CI, 1.2–4.9; P = 0.001), ICU admission (OR, 3.789; 95% CI, 1.913–7.505; P = 0.003), and mortality (OR, 8.084; 95% CI, 3.756–17.397; P = 0.002). Conversely, proteinuria was less significantly associated with the risk of AKI (OR, 1.56; 95% CI, 1.91–7.50; P = 0.003), ICU admission (OR, 2.493; 95% CI, 1.25–4.72; P = 0.001), and mortality (OR, 2.764; 95% CI, 1.368–5.121; P = 0.003). Patients with AKI had a higher probability for mortality than did those without AKI (OR, 14.208; 95% CI, 6.434–31.375; P = 0.003). Conclusion The manifestations of the involvement of the renal system are not uncommon in COVID-19. These manifestations included proteinuria, hematuria, and AKI and were usually associated with a poor prognosis, including high incidences of both ICU admission and mortality.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Manifestations of renal system involvement in hospitalized patients with COVID-19 in Saudi Arabia

et al. 2021

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“…Our translatome data highlighted early changes in immune response proteins after SARS-CoV-2 infection, which, similar to the global protein profile, succumbed to translational attenuation effects at 48 hpi, particularly in PTC. In contrast, the proteomic profile for the latter continued to increase and could explain the cytokine storm associated with SARS-CoV-2 infection and the pro-inflammatory response-driven changes in kidney pathology ( 53 , 71 , 72 , 73 , 74 ). MERS-CoV infection yielded a similar response although DTC showed a more bidirectional effect.…”

Section: Discussionmentioning

confidence: 97%

“…The impact of highly pathogenic coronaviruses including SARS-CoV, MERS-CoV, and recently SARS-CoV-2 on renal pathology has been largely documented for critically ill patients ( 18 , 53 ). Recent clinical reports suggested a high prevalence of AKI in hospitalized cases of COVID-19 (30–78%) associated with increased mortality rates ( 5 , 6 , 45 , 54 , 55 ).…”

Section: Discussionmentioning

confidence: 99%

Proteomic landscape of SARS-CoV-2– and MERS-CoV–infected primary human renal epithelial cells

et al. 2022

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Acute kidney injury is associated with mortality in COVID-19 patients. However, host cell changes underlying infection of renal cells with SARS-CoV-2 remain unknown and prevent understanding of the molecular mechanisms that may contribute to renal pathology. Here, we carried out quantitative translatome and whole-cell proteomics analyses of primary renal proximal and distal tubular epithelial cells derived from human donors infected with SARS-CoV-2 or MERS-CoV to disseminate virus and cell type–specific changes over time. Our findings revealed shared pathways modified upon infection with both viruses, as well as SARS-CoV-2-specific host cell modulation driving key changes in innate immune activation and cellular protein quality control. Notably, MERS-CoV infection–induced specific changes in mitochondrial biology that were not observed in response to SARS-CoV-2 infection. Furthermore, we identified extensive modulation in pathways associated with kidney failure that changed in a virus- and cell type–specific manner. In summary, we provide an overview of the effects of SARS-CoV-2 or MERS-CoV infection on primary renal epithelial cells revealing key pathways that may be essential for viral replication.

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“…ACE 2 receptors are present on the surface of type1 and type 2 pulmonary epithelial cells, but are also present on other cell types, including endothelial cells in vascular tissues throughout the body (Berger 2020, DiNicolantonio & McCarty 2020, Evans et al 2020, Panfoli 2020. Infection with SARS-CoV-2 in humans is associated with systemic inflammatory reactions, most notably in the lung (Stawicki et al 2020), but also in the digestive tract (Aktas & Aslim 2020, Effenberger et al 2020, Garland et al 2020, Hanrahan et al 2020, Villapol 2020; kidney (Joseph et al 2020, Lv et al 2020; brain (Najjar et al 2020, Vargas et al 2020; liver (Garland et al 2020); skin (Gisondi et al 2020) -most likely via endothelial damage to cutaneous blood vessels (Garduño-Soto & Choreño-Parra 2020) -and heart (Basu-Ray et al 2020, Grimaud et al 2020, Kochi et al 2020, Tahir et al 2020, Zou et al 2020. Reports suggest that SARS-CoV-2-associated vascular endothelialitis may underlie the inflammatory reactions occurring in this spectrum of organ systems (Ackermann et al 2020, Evans et al 2020.…”

Section: Introductionmentioning

confidence: 99%

Alert to US physicians: DHEA, widely used as an OTC androgen supplement, may exacerbate COVID-19

Nyce¹

2021

Endocrine-Related Cancer

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Androgens play a fundamental role in the morbidity and mortality of COVID-19, inducing both the ACE-2 receptor to which SARS-CoV-2 binds to gain entry into the cell, and TMPRS22, the transmembrane protease that primes the viral spike protein for efficient infection. The United States stands alone among developed nations in permitting one androgen, oral dehydroepiandrosterone (DHEA), to be freely available OTC and online as a “dietary supplement.” DHEA is widely used by males in the US to offset the age-related decline in circulating androgens. This fact may contribute to the disparate statistics of COVID-19 morbidity and mortality in this country. In regulatory antithesis, every other developed nation regulates DHEA as a controlled substance. DHEA is an extremely potent inhibitor of Glucose-6-phosphate Dehydrogenase (G6PD), with uniquely unstable uncompetitive inhibition kinetics. This has particular relevance to COVID-19, because G6PD-deficient human cells have been demonstrated to be exceptionally sensitive to infection by human coronavirus. Because DHEA is lipophilic and freely passes into cells, oral DHEA bypasses the normal controls regulating androgen biology and uncompetitive G6PD inhibition. DHEA’s status as a “dietary supplement” means that no clinical trials demonstrating safety have been performed, and, in the absence of physician supervision, no data on adverse events has been collected. During the current pandemic, the unrestricted availability of oral DHEA as a “dietary supplement” cannot be considered safe without proof from placebo-controlled clinical trials that it is not contributing to the severity of COVID-19. US physicians may therefore wish to query their patients’ use of DHEA.

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Coronavirus Disease 2019: Coronaviruses and Kidney Injury

Cited by 16 publications

References 48 publications

Manifestations of renal system involvement in hospitalized patients with COVID-19 in Saudi Arabia

Manifestations of renal system involvement in hospitalized patients with COVID-19 in Saudi Arabia

Proteomic landscape of SARS-CoV-2– and MERS-CoV–infected primary human renal epithelial cells

Alert to US physicians: DHEA, widely used as an OTC androgen supplement, may exacerbate COVID-19

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