Renal Involvement and Early Prognosis in Patients with COVID-19 Pneumonia

Abstract

Background Some patients with COVID-19 pneumonia also present with kidney injury, and autopsy findings of patients who died from the illness sometimes show renal damage. However, little is known about the clinical characteristics of kidneyrelated complications, including hematuria, proteinuria, and AKI.Methods In this retrospective, single-center study in China, we analyzed data from electronic medical records of 333 hospitalized patients with COVID-19 pneumonia, including information about clinical, laboratory, radiologic, and other characteristics, as well as information about renal outcomes. ResultsWe found that 251 of the 333 patients (75.4%) had abnormal urine dipstick tests or AKI. Of 198 patients with renal involvement for the median duration of 12 days, 118 (59.6%) experienced remission of pneumonia during this period, and 111 of 162 (68.5%) patients experienced remission of proteinuria. Among 35 patients who developed AKI (with AKI identified by criteria expanded somewhat beyond the 2012 Kidney Disease: Improving Global Outcomes definition), 16 (45.7%) experienced complete recovery of kidney function. We suspect that most AKI cases were intrinsic AKI. Patients with renal involvement had higher overall mortality compared with those without renal involvement (28 of 251 [11.2%] versus one of 82 [1.2%], respectively). Stepwise multivariate binary logistic regression analyses showed that severity of pneumonia was the risk factor most commonly associated with lower odds of proteinuric or hematuric remission and recovery from AKI.Conclusions Renal abnormalities occurred in the majority of patients with COVID-19 pneumonia. Although proteinuria, hematuria, and AKI often resolved in such patients within 3 weeks after the onset of symptoms, renal complications in COVID-19 were associated with higher mortality.

Expression of ACE2 and TMPRSS2 proteins in the upper and lower aerodigestive tracts of rats

“…These results coincide with the reported clinical symptoms of COVID-19, such as loss of taste, loss of olfaction, respiratory dysfunction, and acute nephropathy 16,17 .…”

SARS-COV2 Renal Impairment in Critical Care: A Retrospective Study of 42 Cases - Kid COVID Study

“…In our cohort, 82.5% of critical SARS-CoV-2 patients presented proteinuria, indicating a high rate of intrinsic kidney injury which is in line with Pei et al concerning the Wuhan pandemic (9). In ICU patients, acute tubular necrosis is well documented up to 78% patients in autopsy series (23) whereas this current population of critically ill SARS-CoV-2 patients presented mixed pattern lesions (23,24).…”

Multiple expression assessments of ACE2 and TMPRSS2 SARS-CoV-2 entry molecules in the urinary tract and their associations with clinical manifestations of COVID-19

“…Another retrospective, multi-center cohort study demonstrated the epidemiological and clinical characteristics of 191 COVID-19 patients, of whom 27 individuals were reported to have AKI, and ten were treated with continuous renal replacement therapy (CRRT) 9 . A brief review of existing papers that reported urology system impairment associated with COVID-19 infection is shown in Table 1 [8][9][10][11][12][13][14][15][16][17][18][19] .…”