Novel Evidence of Acute Kidney Injury in COVID-19

Chueh, Ti-I; Zheng, Cai Mei; Hou, Yi‐Chou; Lu, Kuo‐Cheng

doi:10.3390/jcm9113547

Cited by 45 publications

(51 citation statements)

References 96 publications

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“…The effect of COVID-19 on the kidneys is not completely clear. The pathogenesis of SARS-CoV-2–induced AKI is multifactorial and involved several mechanisms, such as the local disruption of RAAS homeostasis, the hemodynamic instability, the cytokine storm, and direct viral cytopathic damage through ACE-2 [ 226 , 230 ].…”

Section: Renal Implication In Covid-19 Diseasementioning

confidence: 99%

Multifaced Roles of HDL in Sepsis and SARS-CoV-2 Infection: Renal Implications

Stasi

Franzin

Fiorentino

et al. 2021

IJMS

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High-density lipoproteins (HDLs) are a class of blood particles, principally involved in mediating reverse cholesterol transport from peripheral tissue to liver. Omics approaches have identified crucial mediators in the HDL proteomic and lipidomic profile, which are involved in distinct pleiotropic functions. Besides their role as cholesterol transporter, HDLs display anti-inflammatory, anti-apoptotic, anti-thrombotic, and anti-infection properties. Experimental and clinical studies have unveiled significant changes in both HDL serum amount and composition that lead to dysregulated host immune response and endothelial dysfunction in the course of sepsis. Most SARS-Coronavirus-2-infected patients admitted to the intensive care unit showed common features of sepsis disease, such as the overwhelmed systemic inflammatory response and the alterations in serum lipid profile. Despite relevant advances, episodes of mild to moderate acute kidney injury (AKI), occurring during systemic inflammatory diseases, are associated with long-term complications, and high risk of mortality. The multi-faceted relationship of kidney dysfunction with dyslipidemia and inflammation encourages to deepen the clarification of the mechanisms connecting these elements. This review analyzes the multifaced roles of HDL in inflammatory diseases, the renal involvement in lipid metabolism, and the novel potential HDL-based therapies.

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Section: Renal Implication In Covid-19 Diseasementioning

confidence: 99%

Multifaced Roles of HDL in Sepsis and SARS-CoV-2 Infection: Renal Implications

Stasi

Franzin

Fiorentino

et al. 2021

IJMS

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“…However, the negative consequences of COVID-19 are also connected with other disorders of the respiratory system [ 1 , 16 , 26 , 27 ], with the cardiovascular system (for review, see [ 1 , 16 , 22 , 26 , 28 , 29 , 30 ]) and with dangerous hematological complications, particularly thromboembolism [ 1 , 16 , 31 , 32 , 33 , 34 , 35 , 36 ]. In addition, pathological changes in the renal [ 1 , 16 , 27 , 33 , 37 , 38 ], gastrointestinal, hepatic, pancreatic [ 1 , 16 , 27 , 31 , 39 , 40 ] and nervous systems [ 1 , 27 , 41 , 42 , 43 ] have been described. Disturbances of the eyes [ 1 , 44 ], endocrine [ 45 , 46 ] and reproductive functions [ 31 , 45 , 46 , 47 ], skeletal muscles [ 1 , 33 , 48 ] and skin [ 1 , 49 , 50 ] occur as well (for details, see Figure 2 ).…”

Section: Mode Of Infection and Symptoms Of Covid-19mentioning

confidence: 99%

Opportunities, Challenges and Pitfalls of Using Cannabidiol as an Adjuvant Drug in COVID-19

Malinowska

Baranowska-Kuczko

Kicman

et al. 2021

IJMS

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may lead to coronavirus disease 2019 (COVID-19) which, in turn, may be associated with multiple organ dysfunction. In this review, we present advantages and disadvantages of cannabidiol (CBD), a non-intoxicating phytocannabinoid from the cannabis plant, as a potential agent for the treatment of COVID-19. CBD has been shown to downregulate proteins responsible for viral entry and to inhibit SARS-CoV-2 replication. Preclinical studies have demonstrated its effectiveness against diseases of the respiratory system as well as its cardioprotective, nephroprotective, hepatoprotective, neuroprotective and anti-convulsant properties, that is, effects that may be beneficial for COVID-19. Only the latter two properties have been demonstrated in clinical studies, which also revealed anxiolytic and antinociceptive effects of CBD (given alone or together with Δ9-tetrahydrocannabinol), which may be important for an adjuvant treatment to improve the quality of life in patients with COVID-19 and to limit post-traumatic stress symptoms. However, one should be aware of side effects of CBD (which are rarely serious), drug interactions (also extending to drugs acting against COVID-19) and the proper route of its administration (vaping may be dangerous). Clearly, further clinical studies are necessary to prove the suitability of CBD for the treatment of COVID-19.

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“…The incidence of AKI in this disorder may be as high as 46% in ICU patients with co-morbidities and requiring respiratory support [ 8 ]. As the complex pathogenesis of renal failure in patients infected with SARS-CoV-2 [ 36 , 37 ] likely includes the outcome of imbalanced renal RAS [ 38 ], it is tempting to assume that the strengthening of the depressor arm of the RAS by means of the administration of ACE2, Ang-(1-7) or other MasR agonists, or inhibiting the pressor arm, for instance with AT1R blockers, might restore the balance between the two arms of the RAS, attenuate disease severity, and perhaps provide renal protection [ 4 , 5 ].…”

Section: Covid-19 Disease: An Archetype Of Imbalanced Rasmentioning

confidence: 99%

Angiotensin-(1-7)—A Potential Remedy for AKI: Insights Derived from the COVID-19 Pandemic

Heyman¹,

Walther

Abassi

2021

JCM

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Membrane-bound angiotensin converting enzyme (ACE) 2 serves as a receptor for the Sars-CoV-2 spike protein, permitting viral attachment to target host cells. The COVID-19 pandemic brought into light ACE2, its principal product angiotensin (Ang) 1-7, and the G protein-coupled receptor for the heptapeptide (MasR), which together form a still under-recognized arm of the renin–angiotensin system (RAS). This axis counteracts vasoconstriction, inflammation and fibrosis, generated by the more familiar deleterious arm of RAS, including ACE, Ang II and the ang II type 1 receptor (AT1R). The COVID-19 disease is characterized by the depletion of ACE2 and Ang-(1-7), conceivably playing a central role in the devastating cytokine storm that characterizes this disorder. ACE2 repletion and the administration of Ang-(1-7) constitute the therapeutic options currently tested in the management of severe COVID-19 disease cases. Based on their beneficial effects, both ACE2 and Ang-(1-7) have also been suggested to slow the progression of experimental diabetic and hypertensive chronic kidney disease (CKD). Herein, we report a further step undertaken recently, utilizing this type of intervention in the management of evolving acute kidney injury (AKI), with the expectation of renal vasodilation and the attenuation of oxidative stress, inflammation, renal parenchymal damage and subsequent fibrosis. Most outcomes indicate that triggering the ACE2/Ang-(1-7)/MasR axis may be renoprotective in the setup of AKI. Yet, there is contradicting evidence that under certain conditions it may accelerate renal damage in CKD and AKI. The nature of these conflicting outcomes requires further elucidation.

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Novel Evidence of Acute Kidney Injury in COVID-19

Cited by 45 publications

References 96 publications

Multifaced Roles of HDL in Sepsis and SARS-CoV-2 Infection: Renal Implications

Multifaced Roles of HDL in Sepsis and SARS-CoV-2 Infection: Renal Implications

Opportunities, Challenges and Pitfalls of Using Cannabidiol as an Adjuvant Drug in COVID-19

Angiotensin-(1-7)—A Potential Remedy for AKI: Insights Derived from the COVID-19 Pandemic

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