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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    COVID-19 and Acute Kidney Injury MESHD Acute Kidney Injury HP requiring Kidney Replacement Therapy: A Bad Prognostic Sign.

    Authors: Rahul Shekhar; Shubhra Upadhyaya; Silvi Shah; Devika Kapuria

    doi:10.1101/2020.05.08.20096040 Date: 2020-05-13 Source: medRxiv

    The development of acute kidney injury MESHD acute kidney injury HP in patients with COVID-19 is estimated to about 0.5% from earlier studies from China. The incidence of AKI in patients with COIVID-19 in the largest inpatient series in the United States is 22.2%3. Development of AKI requiring kidney replacement therapy in hospitalized patients is a bad prognostic sign. Out of Fifty patients admitted to our hospital with COVID-19 13/50(26%) developed AKI. All patients required hospitalization in intensive care unit care and 12/13 required initiation of kidney replacement therapy. The median age TRANS was 41 years (31-85 years) and 50% were men. Common comorbidities were obesity MESHD obesity HP (83%), diabetes (42%), and hypertension MESHD hypertension HP (25%). 10/12 (83%) patients were hypoxemic and required oxygen therapy. 11/12 (92%) patients required invasive ventilation. Majority of patients had elevated neutrophils counts (81.8%) and low lymphocyte counts (81.8%). All patients had chest x-ray findings suggestive of pneumonia MESHD pneumonia HP. 11/12(91.6%) developed septic shock MESHD shock HP requiring vasopressors. Review of UA showed all patient (9/9) had active urine sediments with blood SERO but 7/9 of them have sterile pyuria HP pyuria MESHD. At the end of study period, 1 patient remained hospitalized. 10/11(90%) patients died and one patient was discharged home with resolution of AKI. Median length of stay was 13 days. The exact mechanism of AKI is not well understood in COVID-19 but can be due to acute tubular necrosis HP necrosis MESHD due to septic shock MESHD shock HP because of cytokine storm in severe COVID-19 or direct invasion by SARS-CoV-2 on podocytes and proximal renal tubular cells. Our findings suggest poor prognosis despite continuous kidney replacement therapies in patients who develop AKI with COVID-19.

    Human Kidney is a Target for Novel Severe Acute Respiratory Syndrome MESHD Coronavirus 2 (SARS-CoV-2) Infection MESHD

    Authors: Bo Diao; Chenhui Wang; Rongshuai Wang; Zeqing Feng; Yingjun Tan; Huiming Wang; Changsong Wang; Liang Liu; Ying Liu; Yueping Liu; Gang Wang; Zilin Yuan; Liang Ren; Yuzhang Wu; Yongwen Chen

    doi:10.1101/2020.03.04.20031120 Date: 2020-03-06 Source: medRxiv

    BACKGROUND The outbreak of a novel coronavirus (SARS-CoV-2, previously provisionally named 2019 novel coronavirus or 2019-nCoV) since December 2019 in Wuhan, China, has become an emergency MESHD of major international concern. Apart from the respiratory system, it is unclear whether SARS-CoV-2 can also directly infect other tissues such as the kidney or induce acute renal failure. METHODS We conducted a retrospective analysis of estimated glomerular filtration rate (eGFR) along with other clinical parameters from 85 patients with laboratory-confirmed COVID-19 admitted to a hospital in Wuhan from January 17, 2020 to March 3, 2020. Kidney tissues from six patients with postmortem examinations were analyzed by Hematoxylin and Eosin (H&E) and in situ expression of viral nucleocaspid protein (NP) antigen, immune cell markers (CD8, CD68 and CD56) and the complement C5b-9 was detected by immunohistochemistry. Moreover, the viral particles in kidneys were also investigated by transmission TRANS electronic microscope (EM). RESULTS 27.06% (23/85) patients exhibited acute renal failure (ARF). The eldery patients and cases with comorbidities such as hypertension MESHD hypertension HP and heart failure MESHD more easily developed ARF (65.22% vs 24.19%, p< 0.001; 69.57% vs 11.29%, p< 0.001, respectively). H&E staining demonstrated kidney tissues from postmortems have severe acute tubular necrosis HP necrosis MESHD and lymphocyte infiltration. Immunohistochemistry showed that SARS-CoV-2 NP antigen was accumulated in kidney tubules. EM observation also demonstrated that viruses- like particles are visible in the kidneys. Viral infection MESHD not only induces CD68+ macrophages infiltrated into tubulointerstitium, but also enhances complement C5b-9 deposition on tubules. CONCLUSIONS SARS-CoV-2 induces ARF in COVID-19 patients. Viruses directly infect human kidney tubules to induce acute tubular damage. The viruses not only have direct cytotoxicity, but also initiate CD68+ macrophage together with complement C5b-9 deposition to mediate tubular pathogenesis.

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MeSH Disease
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