A systematic review on COVID-19: urological manifestations, viral RNA detection and special considerations in urological conditions (original) (raw)
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Acute kidney injury in COVID-19; a review on current knowledge
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Coronaviruses are a large family of viruses that can cause a variety of diseases in humans. Some coronaviruses cause only mild illnesses like the common cold. While, some coronaviruses such as SARS-CoV (SARS-associated coronavirus) and Middle East respiratory syndrome coronavirus (MERS-CoV) have, in recent years, been able to cause severe respiratory involvement (pneumonia), leading to death in several patients. By identifying the genomic sequence of the new human coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) it has been revealed that it belongs to the beta coronavirus genus. COVID-19 appears to be transmitted by a mechanism similar to the influenza virus via person to person, sneezing coughing, or contact with the secretions of infected patients. Early symptoms of these respiratory viruses include fever, cough, and shortness of breath, with an incubation period of 2-14 days. SARS-CoV-2 is an acute respiratory disease that initially causes lung damage. SAR...
Outcomes of Kidney involvement with COVID-19 infection
Journal of Nephrology and Renal Management
The recent pandemic caused by the Covid19 / SARS-CoV-2 virus cause disease severity by damaging different organs of human body, kidney is one of the most affected organs. This viral infection may target the kidney in addition to the respiratory system. This peculiar condition is the cause of many health hazard but information on renal involvement in COVID-19 is still limited. As, renal involvement causing several renal damages such as glomerulonephritis,acute kidney damage/injury (AKI)several other nephropathies in COVID-19 growing at a rapid pace, so the best way to manage the effect on individuals with chronic renal disease cases can be studied.
Prevalence and impact of acute renal impairment on COVID-19: a systematic review and meta-analysis
Critical Care
Background: The aim of this study is to assess the prevalence of abnormal urine analysis and kidney dysfunction in COVID-19 patients and to determine the association of acute kidney injury (AKI) with the severity and prognosis of COVID-19 patients. Methods: The electronic database of Embase and PubMed were searched for relevant studies. A meta-analysis of eligible studies that reported the prevalence of abnormal urine analysis and kidney dysfunction in COVID-19 was performed. The incidences of AKI were compared between severe versus non-severe patients and survivors versus non-survivors. Results: A total of 24 studies involving 4963 confirmed COVID-19 patients were included. The proportions of patients with elevation of sCr and BUN levels were 9.6% (95% CI 5.7-13.5%) and 13.7% (95% CI 5.5-21.9%), respectively. Of all patients, 57.2% (95% CI 40.6-73.8%) had proteinuria, 38.8% (95% CI 26.3-51.3%) had proteinuria +, and 10.6% (95% CI 7.9-13.3%) had proteinuria ++ or +++. The overall incidence of AKI in all COVID-19 patients was 4.5% (95% CI 3.0-6.0%), while the incidence of AKI was 1.3% (95% CI 0.2-2.4%), 2.8% (95% CI 1.4-4.2%), and 36.4% (95% CI 14.6-58.3%) in mild or moderate cases, severe cases, and critical cases, respectively. Meanwhile, the incidence of AKI was 52.9%(95% CI 34.5-71.4%), 0.7% (95% CI − 0.3-1.8%) in non-survivors and survivors, respectively. Continuous renal replacement therapy (CRRT) was required in 5.6% (95% CI 2.6-8.6%) severe patients, 0.1% (95% CI − 0.1-0.2%) non-severe patients and 15.6% (95% CI 10.8-20.5%) non-survivors and 0.4% (95% CI − 0.2-1.0%) survivors, respectively. Conclusion: The incidence of abnormal urine analysis and kidney dysfunction in COVID-19 was high and AKI is closely associated with the severity and prognosis of COVID-19 patients. Therefore, it is important to increase awareness of kidney dysfunction in COVID-19 patients.
Critical Care
Dear Editor, Patients infected with SARS-CoV-2 requiring intensive care due to coronavirus disease 2019 (COVID-19) frequently develop acute kidney injury (AKI) [1], but the underlying mechanisms are poorly explored. SARS-CoV-2 has been found in both urine and the kidneys, where it has been suggested to cause proximal tubule damage [2-4]. Direct renal infection of SARS-CoV-2 causing AKI potentially leads to viral shedding in urine. However, to our knowledge, no study has been undertaken to investigate urinary levels of SARS-CoV-2 in patients with AKI. In this report, SARS-CoV-2 RNA levels were prospectively investigated in urine of patients with upper or lower airway swab test PCR-verified COVID-19, admitted to a Swedish intensive care unit (ICU, n = 81). The presented data is part of a study approved by the National Ethical Review Agency (2020-01623). Informed consent was obtained from the patient or next of kin. The Declaration of Helsinki and its subsequent revisions were followed. Nucleic acid was extracted from urine samples using NucliSENS® eMAG® (bioMerieux), and the amount of viral RNA was quantitated by detection of SARS-CoV-2 E and N-genes using real-time RT-PCR according to previously described protocols [5, 6]. For quantitative assessment, the assay was calibrated against a synthetic RNA standard from ATCC and the detection limit was determined to 200 copies/ml. SARS-CoV-2 was found in urine of only 6 patients (7%). The median concentration was 1200 copies/ml (range 300-2800). Urinary viral secretion was not associated with mortality or severity of disease as estimated by Simplified Acute Physiology Score 3 (SAPS3) on admission, length of stay in the ICU, the need for invasive ventilation, or renal replacement therapy (Table 1). Based on changes in plasma creatinine, 51 (63%) patients developed AKI during their ICU stay. Only 5 (10%) of those patients had detectable SARS-CoV-2 RNA levels in the urine. This indicates that urinary secretion of SARS-CoV-2 is uncommon in COVID-19-associated AKI. Furthermore, detection of SARS-CoV-2 RNA in urine was not significantly associated with renal dysfunction and was most frequent in the mildest stage of AKI (Table 1). Of interest is that positive samples in patients with AKI were collected significantly further from onset and peak AKI as compared to negative samples (Table 1). Limitations of the present study include that urine was not sampled repeatedly in the same patient. In case of varying viral secretion, this may have led to an underestimation of the number of patients being positive prior
Epidemiological, clinical and morphological aspects of kidney damage in COVID-19
Journal of Renal Injury Prevention
The mini-review presents modern data on the epidemiology, clinical and morphological aspects of kidney damage in COVID-19. Potential mechanisms of kidney involvement in the clinical picture of the disease may include cytokine damage, cross-organ damage, and systemic effects that determine the treatment strategy. These mechanisms are closely interrelated and are especially important for individuals undergoing extracorporeal therapy and kidney transplants. Autopsy data provide evidence of SARS-CoV-2 virus invasion into kidney tissue with damage to tubular epithelial cells and podocytes, and erythrocyte aggregation in persons with severe COVID-19. By including people with chronic kidney disease in planned COVID-19 research protocols, an evidence base for effective and safe treatments can be generated.
Clinical Profiles in Renal Patients with COVID-19
Journal of Clinical Medicine
The COVID-19 pandemic has led to frequent referrals to the emergency department on suspicion of this infection in maintenance hemodialysis (MHD) and kidney transplant (KT) patients. We aimed to describe their clinical features comparing confirmed and suspected non-confirmed COVID-19 cases during the Spanish epidemic peak. Confirmed COVID-19 ((+)COVID-19) corresponds to patient with positive RT-PCR SARS-CoV-2 assay. Non-confirmed COVID-19 ((−)COVID-19) corresponds to patients with negative RT-PCR. COVID-19 was suspected in 61 patients (40/803 KT (4.9%), 21/220 MHD (9.5%)). Prevalence of (+)COVID-19 was 3.2% in KT and 3.6% in MHD patients. Thirty-four (26 KT and 8 MHD) were (+)COVID-19 and 27 (14 KT and 13 MHD) (−)COVID-19. In comparison with (−)COVID-19 patients, (+)COVID-19 showed higher frequency of typical viral symptoms (cough, dyspnea, asthenia and myalgias), pneumonia (88.2% vs. 14.3%) and LDH and CRP while lower phosphate levels, need of hospital admission (100% vs. 63%), use ...
COVID-19 and acute kidney injury; a case report
Journal of Renal Injury Prevention
Although there is no definitive evidence that coronavirus disease 2019 (COVID-19) affects the kidneys adversely, amongst those who develop severe COVID-19 infection and require hospitalization, acute kidney injury (AKI) was reported. Here, we report the clinical outcome associated with AKI in a 32-year-old man with confirmed COVID-19 infection with no prior history of renal malfunction. The AKI was identified during intensive care unit (ICU) course with the median creatinine and blood urea nitrogen values of 3.1 mg/dL (normal value: 0.6-1.2 mg/dL) and 145 mg/dL (normal value:15-45 mg/dL), respectively. Renal function of patients hospitalized with COVID-19 infection needs to be monitored regularly to intervene as early as possible and to prevent the development of AKI and further kidney complications.
The Dilemma of Renal Involvement in COVID-19: A Systematic Review
Cureus, 2020
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), now known as coronavirus disease 2019 (COVID-19), has posed a serious threat to global health since December 2019. It has spread worldwide and is consuming healthcare resources rapidly. Published literature suggests that people with advanced age and comorbidities are affected more severely. It is crucial to uncover the underlying pathogenesis of acute kidney insufficiency in COVID-19 patients to understand better the reasoning behind the grave outcomes in these patients. In this review, we have included articles stating the prevalence and specific mortality rates of COVID-19 patients with acute kidney insufficiency. Our study included 1098 COVID-19 positive patients, of whom 66 (6%) developed acute kidney insufficiency and 62 patients died, showing a mortality rate of 94%. Patients with acute kidney insufficiency showed a more severe disease course, and these patients ended up more in intensive care units. Particular attention should be paid to those with already established kidney disease, such as chronic kidney disease, or renal transplant recipients, as these patients are already on immunosuppressive therapy. Our review focuses on the prevalence of acute kidney insufficiency in COVID-19 patients and mortality rates in this subset of patients.
Recent Evidence on Acute Kidney Injury in COVID-19 Patients: A Narrative Review
Bioscientia Medicina : Journal of Biomedicine and Translational Research
The pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The clinical manifestation of COVID-19 is broad, ranging from an asymptomatic carrier state to severe disease leading to the death penalty. There is also emerging evidence that kidneys are affected early in COVID-19. Proteinuria and haematuria have been reported in 44% and 26.7% on admission, respectively. This literature review shows clinical manifestations of acute kidney injury (AKI) in a patient with COVID-19 infection. Literature reviews are carried out on various sources found on Google Scholar and Pubmed to search for articles, journal research, case reports, systematic reviews, meta-analyses, and textbooks. Various studies demonstrate the possibility of coronavirus infecting the kidney with several mechanisms such as cytokine storm syndrome (CSS), direct viral infection, and imbalance of renin-angiotensin-aldosterone (RAAS). Haematuria and protein...