COVID-19 Pandemic Causing Acute Kidney Injury and Impact on Patients With Chronic Kidney Disease and Renal Transplantation.
COVID-19 Pandemic Causing Acute Kidney Injury and Impact on Patients With Chronic Kidney Disease and Renal Transplantation.
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DOI：
10.14740/jocmr4200
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发表时间：
2020-06-01
期刊：
影响因子：
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通讯作者：
Konala, Venu Madhav
中科院分区：
文献类型：
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作者：
Adapa, Sreedhar;Chenna, Avantika;Konala, Venu Madhav
由2019年新型冠状病毒（2019-nCoV）引起的2019年冠状病毒病（COVID-19）已造成重大死亡，并已被世界卫生组织宣布为全球大流行病。感染主要表现为发热、咳嗽和呼吸困难，很少有患者出现非常严重的症状。本文旨在分析病毒对肾脏的影响。COVID-19感染导致急性肾损伤（阿基），是死亡的独立风险因素。血管紧张素转换酶2（ACE 2）受体、直接病毒损伤和免疫介导的损伤在发病机制中起重要作用。COVID-19感染中的阿基可能来自病毒诱导的直接亲细胞效应和细胞因子诱导的全身炎症反应的协同作用。已从现有流行病学研究中分析了病毒感染引起的阿基。发生阿基的患者比例在发生严重疾病时明显更高。连续性肾脏替代治疗（CRRT）是需要时最常用的血液净化技术。本文还讨论了COVID-19感染对慢性肾病（CKD）和肾移植患者的影响。到目前为止，还没有针对2019-nCoV病毒的疫苗。管理的关键方面是支持性护理。已经研究了几种研究药物，已经使用了批准用于其他适应症的药物，并且地球仪正在进行几项临床试验。最近，Remdesivir已获得美国食品药品监督管理局（FDA）的紧急使用授权，用于因COVID-19住院的患者。预防感染是管理的关键。有潜在肾脏问题的患者和肾移植患者容易发生COVID-19感染。
Coronavirus disease 2019 (COVID-19) caused by 2019 novel coronavirus (2019-nCoV) has caused significant mortality and has been declared as a global pandemic by the World Health Organization. The infection mainly presents as fever, cough, and breathing difficulty, and few patients develop very severe symptoms. The purpose of this review is to analyze the impact of the virus on the kidney. COVID-19 infection causes acute kidney injury (AKI) and is an independent risk factor for mortality. Angiotensin-converting enzyme 2 (ACE2) receptors, direct viral damage, and immune-mediated damage play important roles in the pathogenesis. AKI in COVID-19 infection could be from the synergistic effect of virus-induced direct cytotropic effect and cytokine-induced systemic inflammatory response. AKI caused in the viral infection has been analyzed from the available epidemiological studies. The proportion of patients developing AKI is significantly higher when they develop severe disease. Continuous renal replacement therapy (CRRT) is the most used blood purification technique when needed. The impact of COVID-19 infection on chronic kidney disease (CKD) and renal transplant patients is also discussed in the manuscript. No vaccine has been developed against the 2019-nCoV virus to date. The critical aspect of management is supportive care. Several investigative drugs have been studied, drugs approved for other indications have been used, and several clinical trials are underway across the globe. Recently remdesivir has received emergency use authorization by the Food and Drug Administration (FDA) in the USA for use in patients hospitalized with COVID-19. Prevention of the infection holds the key to management. The patients with underlying kidney problems and renal transplant patients are vulnerable to developing COVID-19 infection.