Effects of Coronaviruses on the Kidney: A Hypothesis for COVID-19 Induce Nephropathology Except for ACE2 Receptor (original) (raw)
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The clinical characteristics of coronavirus-associated nephropathy
Nephrology Dialysis Transplantation, 2020
We are facing a full-blown pandemic, caused by a recently identified beta-coronavirus [1] now known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical disease, coined coronavirus disease 2019 (COVID-19), is quite heterogeneous. While most patients are asymptomatic or have minor symptoms, a minority of patients develop more serious and potentially life-threatening respiratory disease [2]. In this issue of Nephrology Dialysis Transplantation, Portolés and coworkers report on a large European cohort of patients with COVID-19. They explore kidney involvement as part of the clinical spectrum of SARS-CoV-2 infection [3]. For cell entry, the virus uses a spike protein to bind to an extracellular domain of the human angiotensin-converting enzyme 2 (ACE2) [4, 5]. ACE2 is a carboxypeptidase, hydrolysing single C-terminal amino acids from peptides, e.g. angiotensin I and angiotensin II [6]. High expression levels of ACE2 in the upper and lower airways explain the respiratory tropism of SARS-CoV-2. The kidney is another organ with ACE2 expression, predominantly by proximal tubular cells and podocytes [7]. Until very recently, it was not known whether this would promote kidney tropism. The virus that caused the SARS epidemic in 2003 (SARS-CoV) equally uses ACE2 as a cellular receptor for cell entry. While a minority of SARS-CoV patients did develop acute kidney injury (AKI), this was attributed to critical illness with acute tubular necrosis in post-mortem kidney tissue. With electron microscopy, no viral particles could be detected in these specimens [8]. In kidney tissue obtained at autopsy of 26 critically ill patients with COVID-19, diffuse proximal tubule injury also was the main finding on light microscopy [9]. In a second series of three patients, of which kidney tissue was available in two (one native kidney and one transplanted kidney), clear endotheliitis was noted [10]. In these studies, viruslike particles were observed on electron microscopy in tubular epithelial cells, podocytes and endothelium. However, whether these structures actually are virions is disputed by others [11, 12]. Nevertheless, the presence of SARS-CoV-2 RNA and proteins has convincingly been demonstrated in
Updates on coronavirus (COVID-19) and kidney
Journal of Nephropathology, 2020
The severe acute respiratory syndrome (SARS) is an infectious disease developed in Wuhan, China, at first. It involves the respiratory system and other organs like kidney, gastrointestinal tract and nervous system as well. The recent reports indicated that renal disorder is prevalent in coronavirus patients. The aim of this study was to provide a review of nephropathy caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and its mechanisms. The Web of Science, Scopus, and PubMed databases were systematically searched. Articles reporting nephropathy, coronavirus disease (COVID-19), coronavirus and the renal injury were included for assessment. Study designs, contrast agents, case reports and results were assessed. Of the assessed studies, suggested mechanisms include sepsis which caused cytokine storm syndrome or perhaps direct cellular injury due to the virus. In patients who were studied, albuminuria, proteinuria, and hematuria as well as an elevation in blood urea...
Journal of the College of Physicians and Surgeons Pakistan, 2020
Acute kidney injury (AKI) is relatively common in critically ill coronavirus disease 2019 (COVID-19) patients and it increases mortality and prolongs hospital stay. This article aimed to investigate the history, virology, epidemiology, clinical manifestations, pathophysiology and management of COVID-19 disease, in general, and the pathogenetic mechanisms of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV2)-induced kidney damage, in particular. Keywords like SARS-CoV2, COVID-19, renal impairment, sepsis, viremia, etc. were used to find relevant publications from PubMed, Scopus, Google Scholar, and clinical trials registry websites. According to different studies, kidney involvement in COVID-19 typically occurs in patients who develop acute respiratory distress syndrome (ARDS) or multiorgan failure. The kidney damage in COVID-19 has been shown to be multifactorial, involving direct viral infection, indirect injury by sepsis, hemodynamic alterations, cytokine storm, disseminated intravascular coagulation and other unknown mechanisms. The presence in kidney of angiotensin-converting enzyme 2 (ACE2), a receptor for the virus, has been proven, but few cases of direct viral presence in kidney tissue have been published. Therefore, further studies are needed to investigate the exact mechanisms underlying kidney impairment. Since the development of AKI is one of the important risk factors for mortality in COVID-19 patients, optimal management of AKI may improve the outcomes.
Perspectives on the relationship of renal disease and coronavirus disease 2019
Journal of Nephropharmacology, 2020
Coronavirus disease 2019 (COVID-19) is now a pandemic and its death toll is rocketing up. Patients with acute kidney injury (AKI) and chronic kidney disease (CKD) are at high risk of developing COVID-19 complications and COVID-19 infection can also lead to renal dysfunction. Considering the importance of kidney function in COVID-19 patients, the present review is aimed to dig into the available evidence about kidney and COVID-19. We summarize the mechanisms underlying the renal injury in COVID-19 patients, and treatment strategies in dialysis and kidney transplant patients. We conclude, it is imperative to highlight the early monitoring of patients with AKI and carefully control kidney function during severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infection.
Renal Manifestations of Covid-19: Physiology and Pathophysiology
Journal of Clinical Medicine
Corona virus disease 2019 (COVID-19) imposes a serious public health pandemic affecting the whole world, as it is spreading exponentially. Besides its high infectivity, SARS-CoV-2 causes multiple serious derangements, where the most prominent is severe acute respiratory syndrome as well as multiple organ dysfunction including heart and kidney injury. While the deleterious impact of SARS-CoV-2 on pulmonary and cardiac systems have attracted remarkable attention, the adverse effects of this virus on the renal system is still underestimated. Kidney susceptibility to SARS-CoV-2 infection is determined by the presence of angiotensin-converting enzyme 2 (ACE2) receptor which is used as port of the viral entry into targeted cells, tissue tropism, pathogenicity and subsequent viral replication. The SARS-CoV-2 cellular entry receptor, ACE2, is widely expressed in proximal epithelial cells, vascular endothelial and smooth muscle cells and podocytes, where it supports kidney integrity and func...
Coronavirus infection and kidney disease: a review of current and emerging evidence
Pan African Medical Journal
In November 2009, an outbreak of a new strain of coronavirus (later named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was first noticed in the city of Wuhan in China, rapidly spreading to assume pandemic proportions within a short period of time. The disease was subsequently designated as coronavirus disease-19 (COVID-19). The death toll has continued to rise with grave health and socioeconomic implications for individuals, families and nations globally. Although the respiratory tract is primarily involved in this disease, kidney affectation is increasingly reported and has been shown to worsen the prognosis of the disease. Current evidence shows that kidney disease is not uncommon in patients
COVID-19 and the kidney: A matter of concern
Current Medicine Research and Practice, 2020
Starting from December 2019 in China, SARS-CoV-2, a novel coronavirus strain has rapidly spread to involve more than 150 countries. SARS-CoV-2 is not only responsible for causing pneumonia, but there are also concerns regarding the involvement of other organs such as the heart, liver, and kidneys. Here, we review kidney involvement in COVID 19, the mechanism of kidney injury, and its impact on mortality. Lastly, we focus on the challenges of COVID19 in dialysis and renal transplant patients.
Covid-19 and its relationship with kidney diseases: a scope review
Journal of Human Growth and Development, 2021
Background: COVID-19 is an acute respiratory disease originally from China that emerged in December 2019 and quickly spread around the world, affecting 230,418.415 people, and causing 4,724,876 deaths. Coming from the coronavirus family, SARS-CoV-2 is a new subtype of virus that affects the respiratory tract in different levels and can spread and affect other vital structures in the body. Objective: To identify the risk factors that lead patients infected by the new coronavirus to develop kidney disease. Methods: This is a systematic review of the Scoping Review type (scope review), according to the method proposed by the Joanna Briggs Institute, with the implementation of a checklist structured by PRISMA-ScR that contains 22 mandatory items. The following descriptors were used: coronavirus infection, acute kidney injury and risk factors in five databases, namely PudMed, Scopus, Embase, Virtual Health Library and Web of Science. Results: While reading the studies, it was concluded t...
The Novel Coronavirus 2019 Epidemic and the Kidneys
Journal of Renal and Hepatic Disorders
The Severe Acute Respiratory Syndrome Coronavirus 2 is a recent disease that originated in China by the end of 2019. The origins of the disease can be traced to bats, but it has been transmitted to humans, and the inter-human transmission is particularly rampant which has led to a pan-demic of unseen proportions.The organ principally involved is the lungs, and severe pneumonia with lack of oxygen leads to fatalities.The aim of this review was to study the involvement of the kidneys with regard to COVID-19 infection and how the disease may affect peopleon hemodialysis or those who have undergone a kidney transplant.Indeed, the virus, in addition to the lungs, may affect other vascularized organs to a common receptor on lung epithelium and the endothe-lium of any organ.The kidney, which has a large endothelium surface, is affected, and COVID-19 may lead to acute renal failure.On the other hand, the virus may easily spread among people who are on hemodialysis three times a week. People...