Is the kidney a target of SARS-CoV-2?

Martínez‐Rojas, Miguel Ángel; Vega-Vega, Olynka; Bobadilla, Norma A.

doi:10.1152/ajprenal.00160.2020

Cited by 202 publications

(215 citation statements)

References 91 publications

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“…Meanwhile, another research has shown that the most common kidney abnormalities are subclinical, and acute kidney injury (AKI) is rare (5%) in mild to moderate SARS‐CoV‐2 infection. However, AKI is most common in critically ill patients with COVID‐19 24 . Studies have recently reported that the human kidney is a particular target for SARS‐CoV‐2 infection 23,25,26 and these results might explain the reason for the abnormal kidney indicator found in the present research.…”

Section: Discussionsupporting

confidence: 58%

Severe Coronavirus disease 2019 pneumonia patients showed signs of aggravated renal impairment

Gao

Wang

Wei

et al. 2020

Clinical Laboratory Analysis

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Background This objective of this study was to identify a sensitive indicator of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Methods Samples were collected from 136 patients with Coronavirus disease 2019 (COVID‐19) pneumonia admitted to the Shanghai public health clinical center (116 mild, 20 severe). The concentrations of serum urea, Uric Acid (UA), Creatinine (CREA), Erythrocyte sedimentation rate (ESR), high‐sensitivity C‐reactive protein (hs‐CRP), procalcitonin (PCT), and urine protein (Pro) have been tested in this study. Results Higher levels of urea (female 7.00 ± 3.31, male 8.87 ± 5.18) Pro (female7/7, male 12/13), hs‐CRP (female 2/7, male 5/13) ESR (female 94.43 ± 33.26, male 67.85 ± 22.77) were found in severe patients compared with the mild (urea: female 3.71 ± 1.00, male 4.42 ± 1.14; Pro: female 3/46, male 12/70; hs‐CRP: female 1/46, male 3/70; ESR: female 43.32 ± 33.24, male 21.64 ± 21.82). UA is lower in the severe group (female 146.90 ± 54.01, male 139.34 ± 66.95) than in mild group (female 251.99 ± 64.35, male 339.81 ± 71.32). CREA and PCT did not show a significant difference between mild and severe patients, but the difference among the five biological markers (urea, Pro, hs‐CRP, ESR, and UA) between mild and severe patients we tested was small (P < .05). Conclusion Severe COVID‐19 patients had higher levels of urea and Pro, while their UA levels were lower, reflecting poor kidney function in severe patients. However, higher levels of hs‐CRP, ESR indicated that inflammatory responses were more active in severe patients.

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Section: Discussionsupporting

confidence: 58%

Severe Coronavirus disease 2019 pneumonia patients showed signs of aggravated renal impairment

Gao

Wang

Wei

et al. 2020

Clinical Laboratory Analysis

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“…Additionally, studies have shown that ACE2 is also expressed in other organs, with high expression in the ileum and kidney, followed by adipocytes, heart, brain stem, small intestine enterocytes, stomach, liver, and vasculature, leading to more possibilities of extrapulmonary manifestations. 7 , 8 , 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

Extrapulmonary manifestations of COVID-19 in children: a comprehensive review and pathophysiological considerations

Pousa¹,

Mendonça²,

Oliveira³

et al. 2021

Jornal de Pediatria

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Objective The aim of this review was to summarize the most common extrapulmonary manifestations in pediatric patients with COVID-19, as well as to discuss clinical, epidemiological, and pathophysiological aspects of these clinical presentations in children. Source of data An extensive search of literature was performed in order to identify pediatric cases with extrapulmonary manifestations between January 1, 2020 and June 21, 2020. Generic keywords, such as “Novel coronavirus” or “Novel coronavirus 2019” or “2019 nCoV” or “COVID-19” or “SARS-CoV-2” were searched on PubMed database, associated either with age filters or generic pediatric terms. Summary of findings A total of 28 articles, including 199 patients, were considered suitable to review and data extraction. The main findings were summarized in tables. The main non-pulmonary manifestations in pediatric patients, in decreasing order of frequency, were gastrointestinal, renal, cardiovascular, neurological, hematological and lymphatic, cutaneous, hepatic, ocular, olfactory, and gustatory. Multisystem impairment and Kawasaki-like disease were also described. Conclusions Differences in immune response of children and variations of tissue expression of angiotensin converting enzyme 2, the virus receptor, are likely to influence clinical, epidemiological, and pathophysiological patterns of the disease.

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“…AKI may develop in response to the inflammatory phase and cytokine storm, and be exacerbated by hypercoagulation, microangiopathy, rhabdomyolysis, acute tubular necrosis, hypoxia, and hypotension [ 8 , 37 ]. Proteinuria may be caused by direct infection of SARS-CoV-2 in podocytes and proximal tubular cells [ 38 ]. Because renal abnormalities are associated with a high risk of in-hospital death and appear to be more prevalent in transplant recipients [ 36 ], serum creatinine and urinalysis should be monitored closely.…”

Section: Tests For Transplant Recipients With Covid-19mentioning

confidence: 99%

General Approach to the Clinical Care of Solid Organ Transplant Recipients with COVID-19 Infection

2020

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Purpose of Review Insufficient knowledge about COVID-19 and the potential risks of COVID-19 are limiting organ transplantation in wait-listed candidates and deferring essential health care in solid organ transplant recipients. In this review, we expand the understanding and present an overview of the optimized management of COVID-19 in solid organ transplant recipients. Recent Findings Transplant recipients are at an increased risk of severe COVID-19. The unique characteristics of transplant recipients can make it more difficult to identify COVID-19 . Based on the COVID-19 data to date and our experience, we present testing, management, and prevention methods for COVID-19. Comprehensive diagnostic tests should be performed to determine disease severity, phase of illness, and identify other comorbidities in transplant recipients diagnosed with COVID-19. Outpatients should receive education for preventative measures and optimal health care delivery minimizing potential infectious exposures. Multidisciplinary interventions should be provided to hospitalized transplant recipients for COVID-19 because of the complexity of caring for transplant recipients. Summary Transplant recipients should strictly adhere to infection prevention measures. Understanding of the transplant specific pathophysiology and development of effective treatment strategies for COVID-19 should be prioritized.

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Is the kidney a target of SARS-CoV-2?

Cited by 202 publications

References 91 publications

Severe Coronavirus disease 2019 pneumonia patients showed signs of aggravated renal impairment

Severe Coronavirus disease 2019 pneumonia patients showed signs of aggravated renal impairment

Extrapulmonary manifestations of COVID-19 in children: a comprehensive review and pathophysiological considerations

General Approach to the Clinical Care of Solid Organ Transplant Recipients with COVID-19 Infection

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