COVID-19 and the Kidney: From Epidemiology to Clinical Practice

Gagliardi, Ida; Patella, Gemma; Michael, Ashour; Serra, Raffaele; Provenzano, Michele; Andreucci, Michele

doi:10.3390/jcm9082506

Cited by 88 publications

(115 citation statements)

References 159 publications

(296 reference statements)

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“…AKI in COVID-19 patients is most likely due to multiple mechanisms [ 60 ]. The first is invasion of the virus in the kidney, in which high ACE2 expression may play a role [ 61 ].…”

Section: Covid-19 and Akimentioning

confidence: 99%

COVID-19 in ESRD and Acute Kidney Injury

Kooman

Sande²

2020

Blood Purif

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The COVID-19 pandemic has greatly affected nephrology. Firstly, dialysis patients appear to be at increased risk for infection due to viral transmission next to an enhanced risk for mortality as compared to the general population, even in the face of an often apparently mild clinical presentation. Derangements in the innate and adaptive immune systems may be responsible for a reduced antiviral response, whereas chronic activation of the innate immune system and endothelial dysfunction provide a background for a more severe course. The presence of severe comorbidity, older age, and a reduction of organ reserve may lead to a rapid deterioration of the clinical situation of the patients in case of severe infection. Secondly, patients with COVID-19 are at increased risk of acute kidney injury (AKI), which is related to the severity of the clinical disease. The presence of AKI, and especially the need for renal replacement therapy (RRT), is associated with an increased risk of mortality. AKI in COVID-19 has a multifactorial origin, in which direct viral invasion of kidney cells, activation of the renin-angiotensin aldosterone system, a hyperinflammatory response, hypercoagulability, and nonspecific factors such as hypotension and hypoxemia may be involved. Apart from logistic challenges and the need for strict hygiene within units, treatment of patients with ESRD and COVID-19 is not different from that of the general population. Extracorporeal treatment of patients with AKI with RRT can be complicated by frequent filter clotting due to the hypercoagulable state, for which regional citrate coagulation provides a reasonable solution. Also, acute peritoneal dialysis may be a reasonable option in these patients. Whether adjuncts to extracorporeal therapies, such as hemoadsorption, provide additional benefits in the case of severely ill COVID-19 patients needs to be addressed in controlled studies.

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“…AKI in COVID-19 patients is most likely due to multiple mechanisms [ 60 ]. The first is invasion of the virus in the kidney, in which high ACE2 expression may play a role [ 61 ].…”

Section: Covid-19 and Akimentioning

confidence: 99%

COVID-19 in ESRD and Acute Kidney Injury

Kooman

Sande²

2020

Blood Purif

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“…In a recent study based on the analysis of several clinical reports, Gagliardi et al [85] related that up to 15% of the hospitalized COVID-19 patients had at least one kidney abnormality represented by increased BUN and reduced GFR, as well as 26-63% of patients presented proteinuria at admission or developed proteinuria during their stay in hospital. Moreover, the incidence of AKI in COVID-19 patients varied from 0.5% to 23%, with an interval from baseline visit to the onset of AKI of 7-15 days in median, and that mortality from the COVID-19 patients who developed AKI could be up to 13 times higher than those infected patients without clinical signs of AKI.…”

Section: Coronavirus and Acute Kidney Injurymentioning

confidence: 99%

“…Moreover, the incidence of AKI in COVID-19 patients varied from 0.5% to 23%, with an interval from baseline visit to the onset of AKI of 7-15 days in median, and that mortality from the COVID-19 patients who developed AKI could be up to 13 times higher than those infected patients without clinical signs of AKI. In addition, the authors suggested that the high prevalence of kidney involvement at hospital admission of some COVID-19 patients may be associated with some factors, including report of previous renal impairments, patients' age, severity of illness, and presence of diabetes and/or heart failure, which are all risk factors for AKI that contribute to a pro-inflammatory state with functional defects in their immune system, worsening the clinical conditions of COVID-19 patients [85].…”

Section: Coronavirus and Acute Kidney Injurymentioning

confidence: 99%

“…Thus, some relevant factors related to both clinical trials and quercetin need to be further verified for a future broad application in humans. For example, the type of subject, their level of health, illness severity, and presence of comorbidities are some of factors that might affect the results and should be considered by physicians and researchers [85]. Moreover, route of administration, formulation, and toxicity are parameters linked to pharmacological properties of quercetin that must also be evaluated beforehand [86][87][88][89].…”

Section: Quercetin: a Helpful Therapeutic Drug Against Sars-cov-2-indmentioning

confidence: 99%

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Mechanistic Aspects and Therapeutic Potential of Quercetin against COVID-19-Associated Acute Kidney Injury

Diniz¹,

Souza

Duarte

et al. 2020

Molecules

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The inflammatory mediator and oxidant agent storm caused by the SARS-CoV-2 infection has been strongly associated with the failure of vital organs observed in critically ill patients with coronavirus disease 2019 (COVID-19) and the death of thousands of infected people around the world. Acute kidney injury (AKI) is a common renal disorder characterized by a sudden and sustained decrease in renal function with a critical influence on poor prognosis and lethal clinical outcomes of various etiologies, including some viral infection diseases. It is known that oxidative stress and inflammation play key roles in the pathogenesis and development of AKI. Quercetin is a natural substance that has multiple pharmacological properties, such as anti-inflammatory action, and is used as a dietary supplement. There is evidence of the anti-coronavirus activities of this compound, including against the target SARS-CoV-2 3CLpro. The ability to inhibit coronavirus and its inflammatory processes is strongly desired in a new drug for the treatment of COVID-19. Therefore, in this review, the dual effect of quercetin is discussed from a mechanistic perspective in relation to AKI kidney injury and its nephroprotective potential to SARS-CoV-2 patients.

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“…Current data [7] revealed that the impact of COVID-19 presents certain peculiar aspects in different nations that have been deeply investigated. Some authors hypothesised that virus mutations were responsible for these differences [8,9,10]. Nevertheless, many independent studies agreed that the mutations did not have a primary role in the differentiation of the outcomes [11,12,13].…”

Section: Introductionmentioning

confidence: 99%

Intersection between ageing-related Genes and SARS-CoV-2 Interactome: Is it higher than expected?

Guzzi¹,

Pedace²,

Giorgi

2020

Preprint

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Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease, 2019; COVID-19) is associated with adverse outcomes in patients. It has been observed that lethality seems to be related to the age of patients. Moreover, it has been demonstrated that ageing causes some modifications at a molecular level.Objective The study aims to investigate a possible link between the increased COVID-19 lethality and the molecular changes that occur in elderly people.Methods We considered publicly available datasets on ageing-related genes and SARS-CoV-2 interactors. Then, for each SARS-CoV-2 protein interactor, we tested for the enrichment of ageing-related proteins. Finally, we performed a network-based analysis to identify which molecular mechanisms could play a role in the SARS-CoV-2 molecular aetiology and ultimately affect COVID-19 outcome.Results We observed a significant intersection between some SARS-CoV-2 interactors and ageing-related genes. Our analysis evidenced that virus infection particularly affects ageing molecular mechanisms centred around proteins EEF2, NPM1, HMGA1, HMGA2, APEX1, CHEK1, PRKDC, and GPX4.Conclusion Our study generated a mechanistic framework aiming at explaining the correlation between COVID-19 incidence in elderly patients and molecular mechanisms of ageing. This will provide testable hypotheses for future investigation on the mechanism of action of coronaviruses and pharmacological solutions tailored on specific age ranges.

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COVID-19 and the Kidney: From Epidemiology to Clinical Practice

Cited by 88 publications

References 159 publications

COVID-19 in ESRD and Acute Kidney Injury

COVID-19 in ESRD and Acute Kidney Injury

Mechanistic Aspects and Therapeutic Potential of Quercetin against COVID-19-Associated Acute Kidney Injury

Intersection between ageing-related Genes and SARS-CoV-2 Interactome: Is it higher than expected?

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