Case 17-2020: A 68-Year-Old Man with Covid-19 and Acute Kidney Injury

Sise, Meghan E.; Baggett, Meridale V; Shepard, Jo-Anne O.; Stevens, Jacob S.; Rhee, Eugene P.

doi:10.1056/nejmcpc2002418

Cited by 71 publications

(66 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…They also reported 12 patients (8%) were treated by extracorporeal membrane oxygenation (ECMO), and among them, thrombotic occlusions of centrifugal pump occurred in 2 patients. Methods to minimize extracorporeal circuit clotting include prefilter infusion of heparin and the use of citrate-based replacement fluid for dialysis are not always successful [46]. The reason for the high incidence of CRRT filter and ECMO oxygenator coagulation is not known, but factors other than endotheliopathy such as hypercoagulability, hypofibrinolysis, and platelet activation must attribute.…”

Section: Clot Formation In Extracorporeal Circuitsmentioning

confidence: 99%

The coagulopathy, endotheliopathy, and vasculitis of COVID-19

2020

View full text Add to dashboard Cite

Background COVID-19-associated coagulopathy (CAC) characterized by the elevated D-dimer without remarkable changes of other global coagulation markers is associated with various thrombotic complications and disease severity. The purpose of this review is to elucidate the pathophysiology of this unique coagulopathy. Methods The authors performed online search of published medical literature through PubMed using the MeSH (Medical Subject Headings) term "COVID-19," "SARS-CoV-2," "coronavirus," "coagulopathy," and "thrombus." Then, selected 51 articles that closely relevant to coagulopathy in COVID-19. Results The primary targets of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are the pneumocytes, immune cells, and vascular endothelial cells. The alveolar damage and the pulmonary microvascular thrombosis are the major causes of acute lung injury in COVID-19. The endotheliopathy that occurs is due to direct SARS-CoV-2 infection and activation of other pathways that include the immune system and thromboinflammatory responses leading to what is termed CAC. As a result, both microvascular and macrovascular thrombotic events occur in arterial, capillary, venule, and large vein vascular beds to produce multiorgan dysfunction and thrombotic complications. In addition to the endothelial damage, SARS-CoV-2 also can cause vasculitis and presents as a systemic inflammatory vascular disease. Clinical management of COVID-19 includes anticoagulation but novel therapies for endotheliopathy, hypercoagulability, and vasculitis are needed. Conclusion The endotheliopathy due to direct endothelial infection with SARS-COV-2 and the indirect damage caused by inflammation play the predominant role in the development of CAC. The intensive control of thromboinflammation is necessary to improve the outcome of this highly detrimental contagious disease.

show abstract

Section: Clot Formation In Extracorporeal Circuitsmentioning

confidence: 99%

The coagulopathy, endotheliopathy, and vasculitis of COVID-19

2020

View full text Add to dashboard Cite

show abstract

“…A nonpharmacological option for COVID-19 to counteract the dysregulated proinflammatory response could be represented by blood purification techniques [56, 57]. Nevertheless, the application of these techniques in COVID-19 patients is still not widespread and further investigation is needed to confirm their beneficial effects.…”

Section: Blood Purificationmentioning

confidence: 99%

Weathering the Cytokine Storm in COVID-19: Therapeutic Implications

et al. 2020

View full text Add to dashboard Cite

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recently emerged in Wuhan, Hubei-China, as responsible for the coronavirus disease 2019 (COVID-19) and then spread rapidly worldwide. While most individuals remain asymptomatic or develop only mild symptoms, approximately 5% develop severe forms of COVID-19 characterized by acute respiratory distress syndrome (ARDS) and multiple-organ failure (MOF) that usually require intensive-care support and often yield a poor prognosis. Summary: The pathophysiology of COVID-19 is far from being completely understood, and the lack of effective treatments leads to a sense of urgency to develop new therapeutic strategies based on pathophysiological assumptions. The exaggerated cytokine release in response to viral infection, a condition known as cytokine release syndrome (CRS) or cytokine storm, is emerging as the mechanism leading to ARDS and MOF in COVID-19, thus endorsing the hypothesis that properly timed

show abstract

“…It is interesting to note that AKI cases with Covid-19 seem to reproduce this diversity. The etiologic factors involved are multiple and include direct viral cytopathic effect, decreased blood oxygen content and renal plasma flow, angiotensin II activation, glomerulopathies, crosstalk injury, inflammatory deregulation, hyperviscosity, thrombotic microangiopathy, secondary sepsis and drug toxicity 3,[6][7][8][10][11][12][13][14] .…”

Section: Causes Of Acute Kidney Injury With Covid-19mentioning

confidence: 99%

“…This coagulopathy can also interfere with RRT provision. Decreased filter and extracorporeal circuit lifespan has been reported frequently with Covid-19 12 .…”

Section: Anticoagulationmentioning

confidence: 99%

Technical note and clinical instructions for Acute Kidney Injury (AKI) in patients with Covid-19: Brazilian Society of Nephrology and Brazilian Association of Intensive Care Medicine

et al. 2020

View full text Add to dashboard Cite

We produced this document to bring pertinent information to the practice of nephrology, as regards to the renal involvement with COVID-19, the management of acute kidney injury cases, and practical guidance on the provision of dialysis support.As information on COVID-19 evolves at a pace never before seen in medical science, these recommendations, although based on recent scientific evidence, refer to the present moment. The guidelines may be updated when published data and other relevant information become available.

show abstract

Case 17-2020: A 68-Year-Old Man with Covid-19 and Acute Kidney Injury

Cited by 71 publications

References 31 publications

The coagulopathy, endotheliopathy, and vasculitis of COVID-19

The coagulopathy, endotheliopathy, and vasculitis of COVID-19

Weathering the Cytokine Storm in COVID-19: Therapeutic Implications

Technical note and clinical instructions for Acute Kidney Injury (AKI) in patients with Covid-19: Brazilian Society of Nephrology and Brazilian Association of Intensive Care Medicine

Contact Info

Product

Resources

About