COVID-19 and the Inpatient Dialysis Unit

Burgner, Anna; İkizler, T. Alp; Dwyer, Jamie P.

doi:10.2215/cjn.03750320

Cited by 80 publications

(30 citation statements)

References 11 publications

(10 reference statements)

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“…Such information calls for patient care regarding the renal function of patients currently under emergency and potential post-cure treatment for kidney recovery. Furthermore, several authors have published regarding patients affected by diabetes [65][66][67][68][69][70][71][72], and those undergoing kidney transplant [73][74][75][76]. In particular, Muniyappa et al [71] discussed potential mechanisms by which diabetes modulates host-viral interactions and host-immune responses.…”

Section: Discussionmentioning

confidence: 99%

The kidney, COVID-19, and the chemokine network: an intriguing trio

et al. 2020

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On December 30th 2019, some patients with pneumonia of unknown etiology were reported in the Program for Monitoring Emerging Diseases (ProMED), a program run by the International Society for Infectious Diseases (ISID), hypothesized to be related to subjects who had had contact with the seafood market in Wuhan, China. Chinese authorities instituted an emergency agency aimed at identifying the source of infection and potential biological pathogens. It was subsequently named by the World Committee on Virus Classification as 2019-nCoV (2019-novel coronavirus) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A number of studies have demonstrated that 2019-nCoV and the SARS-CoV shared the same cell entry receptor named angiotensin-converting enzyme 2 (ACE2). This is expressed in human tissues, not only in the respiratory epithelia, but also in the small intestines, heart, liver, and kidneys. Here, we examine the most recent findings on the effects of SARS-CoV-2 infection on kidney diseases, mainly acute kidney injury, and the potential role of the chemokine network.

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Section: Discussionmentioning

confidence: 99%

The kidney, COVID-19, and the chemokine network: an intriguing trio

et al. 2020

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“…But the need for such planning became glaringly clear as shortages of dialysis services became significant worldwide. 19 The American Society of Nephrology recently published its recommendations on managing dialysis resources during contingency planning pre-crisis 20 while other centers began sharing their experience with dialysis rationing. 21 The ASN's "practical ideas for increasing dialysis surge capacity" included fluid restriction, use of potassium binding resins, and "total nephron blockade" to increase urine output; limiting intermittent dialysis times to 3 hours, twice weekly (Monday-Thursday; Tuesday-Friday; Wednesday-Saturday).…”

Section: Discussionmentioning

confidence: 99%

<p>Inpatient Dialysis Planning During the COVID-19 Pandemic: A Single-Center Experience and Review of the Literature</p>

Mitchell¹,

Bomm²,

Shea³

et al. 2020

IJNRD

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Background: COVID-19 has created havoc in healthcare systems worldwide, including shortages in equipment and supplies for dialysis in the acute setting. Methods: We compared our planning and experience at a tertiary care academic medical center to recommendations in the literature. Results: Published literature and our experience underscored the need to plan for adequate dialysis equipment, particularly for continuous renal replacement therapy in the ICU setting, adequate nursing, and flexible scheduling of chronic patients to accommodate the surge in acute patients. We discovered other "shortages" not mentioned in the literature: shortages in the number of portable reverse osmosis (RO) machines needed to prepare dialysis water, inadequate number of rooms in units designated for COVID-19 patients with plumbing for dialysis, and lack of temperature blending valves on sinks that necessitated using cold water only, and damaging the RO membranes. We identified the need for cooperation between nephrology and critical care medicine, hospital-based and community nephrologists and community dialysis units as well as nephrologists at other hospitals in the region. We turned to guidance from the hospital ethics committee. Conclusion: Planning for an expected surge in hospitalized patients requiring RRT demands coordination between critical care, dialysis and nursing services as well as community and hospital providers to make certain there are adequate dialysis resources. Our experience suggests that continuous dialysis is in greatest demand early in the illness, and that plans to increase supplies should be put in place. But, planning should also focus on unforeseen hospital-specific infrastructure shortages that can develop over time and hamper intermittent dialysis delivery to all patients who require treatment.

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“…[25] The presence of this cleavage site also increased damage to the respiratory and urinary systems, paralleling SARS-CoV-2 systemic multiorgan symptoms-especially reports that infection with the novel coronavirus not only targets the lungs where it binds to ACE2 receptors, but also the entire cardiovascular system, [27] the nervous system, [28] and our kidneys as well. [29] It might be more than a coincidence that the Vero cells often used in serial passage are derived from kidney epithelial cells extracted from African green monkeys, which have ACE2 receptors very similar to those found in humans and would be shared by the humanized mice that are also used for serial passage research.…”

Section: Serial Passage and Its Molecular Signaturesmentioning

confidence: 99%

Might SARS‐CoV‐2 Have Arisen via Serial Passage through an Animal Host or Cell Culture?

Sirotkin¹,

Sirotkin²

2020

BioEssays

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Despite claims from prominent scientists that SARS-CoV-2 indubitably emerged naturally, the etiology of this novel coronavirus remains a pressing and open question: Without knowing the true nature of a disease, it is impossible for clinicians to appropriately shape their care, for policy-makers to correctly gauge the nature and extent of the threat, and for the public to appropriately modify their behavior. Unless the intermediate host necessary for completing a natural zoonotic jump is identified, the dual-use gain-of-function research practice of viral serial passage should be considered a viable route by which the novel coronavirus arose. The practice of serial passage mimics a natural zoonotic jump, and offers explanations for SARS-CoV-2's distinctive spike-protein region and its unexpectedly high affinity for angiotensin converting enzyme (ACE2), as well as the notable polybasic furin cleavage site within it. Additional molecular clues raise further questions, all of which warrant full investigation into the novel coronavirus's origins and a re-examination of the risks and rewards of dual-use gain-of-function research.

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COVID-19 and the Inpatient Dialysis Unit

Cited by 80 publications

References 11 publications

The kidney, COVID-19, and the chemokine network: an intriguing trio

The kidney, COVID-19, and the chemokine network: an intriguing trio

<p>Inpatient Dialysis Planning During the COVID-19 Pandemic: A Single-Center Experience and Review of the Literature</p>

Might SARS‐CoV‐2 Have Arisen via Serial Passage through an Animal Host or Cell Culture?

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