Renal Involvement in COVID-19: A Review of the Literature

Migliaccio, Marco Giuseppe; Mauro, Marco Di; Ricciolino, Riccardo; Spiniello, Giorgio; Carfora, Vincenzo; Verde, Nicoletta; Mottola, Filiberto Fausto; Coppola, Nicola

doi:10.2147/idr.s288869

Cited by 24 publications

(39 citation statements)

References 61 publications

(71 reference statements)

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“…It is more frequent in critically ill patients. Different mechanisms have been described: Direct effect of the virus and secondary mechanisms linked to the hemodynamic (hypo-perfusion), thrombotic micro-angiopathy, humoral response to the virus, and activation of the complement system [41]. Histologically, nonspecific acute or subacute tubular necrosis was observed in five of our patients and none of them had lymphocyte infiltration.…”

Section: Discussionmentioning

confidence: 65%

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Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy

Malézieux-Picard¹,

Soler

Ferreira³

et al. 2021

JCM

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Background: Mechanisms and causes of death in older patients with SARS-CoV-2 infection are still poorly understood. Methods: We conducted in a retrospective monocentric study, a clinical chart review and post-mortem examination of patients aged 75 years and older hospitalized in acute care and positive for SARS-CoV-2. Full body autopsy and correlation with clinical findings and suspected causes of death were done. Results: Autopsies were performed in 12 patients (median age 85 years; median of 4 comorbidities, mainly hypertension and cardiovascular disease). All cases showed exudative or proliferative phases of alveolar damage and/or a pattern of organizing pneumonia. Causes of death were concordant in 6 cases (50%), and undetected diagnoses were found in 6. Five patients died from hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19), five had another associated diagnosis and two died from alternative causes. Deaths that occurred in the second week were related to SARS-CoV-2 pneumonia whereas those occurring earlier were related mainly to heart failure and those occurring later to complications. Conclusions: Although COVID-19 hypoxemic respiratory failure was the most common cause of death, post-mortem pathological examination revealed that acute decompensation from chronic comorbidities during the first week of COVID-19 and complications in the third week contributed to mortality.

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Section: Discussionmentioning

confidence: 65%

“…Acute renal failure was also common and related to decompensated chronic vascular and diabetic nephropathies. The incidence of acute kidney injury (AKI) during SARS-CoV-2 infection varies from 0.5% to 80.3% [41]. It is more frequent in critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy

Malézieux-Picard¹,

Soler

Ferreira³

et al. 2021

JCM

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“…Rhabdomyolysis is commonly observed in COVID-19. It can lead to high levels of serum phosphokinase creatinine (more than five times the upper bound of ordinary) and could be another critical factor in ARI development [65].…”

Section: Renal Involvementmentioning

confidence: 99%

From asymptomatic to critical illness: Decoding various clinical stages of Covid-19

2021

Turk J Med Sci

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The clinical course of COVID-19 is variable, with clinical manifestation ranging from 81% mild course to 14% severe course along with 5% critical course in patients. The asymptomatic course is reported to potentially range between 20-70% (avg. 33%). A more severe course is seen in the elderly, those with various chronic diseases, and the immunosuppressed, where the case fatality rate is higher in these risk groups. The disease progresses with various symptoms, such as fever, cough, shortness of breath, malaise, myalgia, taste and smell disorders, diarrhea, sore throat, headache and conjunctivitis. The disease begins with shortness of breath, indicative of lung damage, after an average of 7 to 10 days, and progresses in ARDS, sepsis, and septic shock. Some patients quickly enter shortness of breath, while others gradually develop shortness of breath and chest tightness and burning. The risk factors for a poor prognosis are age, comorbidities, and changes in laboratory tests. Secondary bacterial and fungal infections frequently develop in connection with steroids and immunosuppressants, especially in patients followed in the intensive care unit. Frequent complications in hospitalized patients include pneumonia (75%), ARDS (15%), acute renal failure (9%), and acute liver injury (19%). An increased incidence of heart damage is observed, including acute heart failure, arrhythmias, and myocarditis. 10-25% of the patients hospitalized due to COVID-19 present with prothrombotic coagulopathy, resulting in venous and arterial thromboembolic events. The most common extra-pulmonary symptom is neuropsychiatric involvement, frequently accompanied by insomnia, an impediment to remembering, and an altered state of consciousness. During the course of COVID-19, patients undergo some pathological changes (severe lymphopenia, high levels of CRP, D-dimer, ferritin, etc.) depending on the condition and exposure level of the affected systems as shown by various laboratory tests, and the relevant tests are the guiding elements of risk assessment, clinical monitoring, disease severity, and prognosis setting and therapy decision-making processes.

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“…Another study from France reported 47% patients with confirmed COVID-19 had anosmia 11 . The pathophysiological mechanism underlying the occurrence of anosmia is still not wellunderstood, but two explanations have been proposed 12 .…”

Section: Table-v Distribution Of Factors Associated With In Hospital Outcome Of Study Population (N=769)mentioning

confidence: 99%

“…However, most affected individuals are healthy asymptomatic carriers or have minor symptoms 3 . SARS-CoV-2 not only involves lung, but may also affect the cardiovascular system [4][5][6] , gastrointestinal system 7,8 , central nervous system [9][10][11] , renal system 12 and skin 13 . The SARS-CoV-2 protein characteristic spike binds to its cellular receptor, the angiotensin-converting enzyme 2 (ACE2), which is widely expressed in many cell types and organs like lung alveolar cells, nasal epithelium, cerebral cortex, digestive tract, kidney, gallbladder, testis, and adrenal gland 11 .…”

Section: Introductionmentioning

confidence: 99%

Coronavirus Disease 2019: One Year Experience at Tertiary Care Cardiac Hospital

et al. 2021

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Background: The Coronavirus Disease 2019 (COVID-19) pandemic is a significant challenge particularly for low and middle-income countries like Bangladesh. Interventions such as home isolation, frequent hand washing, wearing face mask, maintaining social distancing are difficult to implement in densely populated areas. The aim of the study was to delineate demographics, clinical manifestations, treatment modalities and outcomes of COVID-19 affected patients of our hospital. Methods: This prospective observational study was carried out at National Heart Foundation Hospital & Research Institute of Bangladesh between 08 March 2020 to 07 March 2021. During this period all admitted patients who subsequently were diagnosed as COVID positive and health care personnel of this hospital, who experienced fever or respiratory symptoms or came in close contact with COVID-19 patients at home or their workplace & become COVID positive were included. Results: During this one-year period a total of 769 COVID positive patients were detected in our hospital. Mean age of the patients was 48.16 ±15.63 years (range 1-92 years). Two third were male (64.9% vs 35.1%) and had multiple co-morbidities. One fifth of the patients were (19%) asymptomatic. The mean duration of onset of symptoms to test was 3.72±3.7 days. Most common symptoms were fever (65.3%), cough (37.1%), shortness of breath (33.6%) and fatigue (27.8%). Other symptoms were bodyache (18.6%), headache (16.6%), anosmia 16%), sore throat (12.1%), diarrhoea (6.8%), dizziness (5.3%), generalized itching (3.8%). Nearly two third of the COVID positive patients (63.2%) had a diagnosed cardiovascular disease at onset and remaining 36.8% patients presented with only COVID-19 disease. About 75% patients received ivermectin, 5.1% patients received favipiravir and 4.4% patients received remdesivir. Three fourth (74.38%) of patients were hospitalized and remaining one fourth (25.62%) patients were treated either in home isolation or in institutional isolation. Most of the patients recovered, with a case fatality rate of 3.5%. Diabetes, hypertension and age ≥50 years were the independent predictors of mortality. Conclusion: Although most of the patients had good outcome the study revealed 3.5% case fatality. Male with multiple co-morbidities were predominantly affected by COVID 19. Fever, cough, shortness of breath and fatigue were common presenting symptoms. Bangladesh Heart Journal 2021; 36(2): 89-97

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Renal Involvement in COVID-19: A Review of the Literature

Cited by 24 publications

References 61 publications

Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy

Undetected Causes of Death in Hospitalized Elderly with COVID-19: Lessons from Autopsy

From asymptomatic to critical illness: Decoding various clinical stages of Covid-19

Coronavirus Disease 2019: One Year Experience at Tertiary Care Cardiac Hospital

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