Renal changes and acute kidney injury in covid-19: a systematic review

Abstract

SUMMARY OBJECTIVE We aimed to present a review of renal changes in patients with COVID-19. METHODS We performed a systematic review of the literature to identify original articles regarding clinical, laboratory, and anatomopathological kidney changes in patients infected with SARS-CoV-2 published until May 7, 2020. The search was carried out across PubMed, Scopus, and Embase using the keywords “COVID-19”, “coronavirus”, “SARS-CoV-2”, “kidney injury” and “kidney disease”. Fifteen studies presented clinical and laboratory renal changes in patients with COVID-19, and three addressed anatomopathological changes. DISCUSSION Acute kidney injury (AKI) was a relevant finding in patients with COVID-19. There were also significant changes in laboratory tests that indicated kidney injury, such as increased serum creatinine and blood urea nitrogen (BUN), proteinuria, and hematuria. The presence of laboratory abnormalities and AKI were significant in severely ill patients. There was a considerable prevalence of AKI among groups of patients who died of COVID-19. Histopathological analysis of the kidney tissue of patients infected with SARS-CoV-2 suggested that the virus may directly affect the kidneys. CONCLUSION Although COVID-19 affects mainly the lungs, it can also impact the kidneys. Increased serum creatinine and BUN, hematuria, proteinuria, and AKI were frequent findings in patients with severe COVID-19 and were related to an increased mortality rate. Further studies focusing on renal changes and their implications for the clinical condition of patients infected with the novel coronavirus are needed.

Predicting In‐Hospital Mortality in COVID‐19 Older Patients with Specifically Developed Scores

“…ISARIC‐4C includes blood urea nitrogen and CRP, whereas COVID‐GRAM include lactate dehydrogenase (LDH) and direct bilirubin. CRP and LDH were already described to be associated to advanced pulmonary disease in COVID‐19, 25,26 as well as kidney damage and increased blood urea nitrogen, 27 as confirmed in our study. Conversely, we cannot confirm the usefulness of bilirubin evaluation since the hepatic involvement in our cohort was limited.…”

Conduction System Disease and Atrioventricular Block in Victims of COVID-19 in Iran

“…However, potential reported triggers are as follows [18]. First, electrolyte imbalance caused by COVID-19 symptoms such as diarrhea and complications such as acute kidney injury or severe sepsis are notable causes [19]. Second, SARS-CoV-2-induced myocardial injury due to upregulation of ACE2 receptor during viral invasion and severe hypoxia-induced myocyte necrosis are another potential causes on arrhythmias [20].…”

COVID‑19 pandemic and reasons to prioritize the needs of the health care system to ensure its sustainability: A scoping review from January to October 2020 (Review)

“…Likewise, an exaggerated risk of venous thromboembolism ( 72 ), venous and arterial ( 73 ), pulmonary ( 74 ) and thromboembolic complications ( 75 ) is prevalent in COVID-19 patients. Acute kidney impairment is another major reported complication affecting the function of the kidneys post-infection ( 76 ), while liver injury and impaired function are also not uncommon ( 77 ). Several disorders affecting the central nervous system have been registered in the literature, including meningoencephalitis, encephalopathy, seizures and neuropsychiatric complications ( 78 ), as well as peripheral complications, including Guillain-Barré and Miller-Fischer syndrome ( 58 ), insinuating a pathogenic link to COVID-19 infection ( 79 ).…”