COVID-19 and Kidney Disease: Update on Epidemiology, Clinical Manifestations, Pathophysiology and Management
COVID-19 and Kidney Disease: Update on Epidemiology, Clinical Manifestations, Pathophysiology and Management
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DOI：
10.29271/jcpsp.2020.supp2.s19
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发表时间：
2020-06-01
影响因子：
1
通讯作者：
Alirezaei, Amirhesam
中科院分区：
文献类型：
--
作者：
Asgharpour, Masoumeh;Zare, Elham;Alirezaei, Amirhesam
急性肾损伤（阿基）在2019冠状病毒病（COVID-19）重症患者中相对常见，它会增加死亡率和住院时间。本文旨在研究COVID-19疾病的历史、病毒学、流行病学、临床表现、病理生理学和管理，特别是严重急性呼吸窘迫综合征冠状病毒2（SARS-CoV 2）诱导的肾损害的发病机制。使用SARS-CoV 2、COVID-19、肾损害、脓毒症、病毒血症等关键词从PubMed、Scopus、Google Scholar和临床试验注册网站查找相关出版物。根据不同的研究，COVID-19的肾脏受累通常发生在发生急性呼吸窘迫综合征（ARDS）或多器官衰竭的患者中。COVID-19的肾脏损害已被证明是多因素的，涉及直接病毒感染、败血症间接损伤、血流动力学改变、细胞因子风暴、弥散性血管内凝血和其他未知机制。血管紧张素转换酶2（ACE 2），一种病毒的受体，在肾脏中的存在已被证明，但在肾组织中直接存在病毒的病例很少。因此，需要进一步的研究来探讨肾损害的确切机制。由于阿基的发展是COVID-19患者死亡的重要风险因素之一，因此阿基的最佳管理可能会改善结局。
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.