Renal Considerations in COVID-19: Biology, Pathology, and Pathophysiology.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has emerged into a worldwide pandemic of epic proportion. Beyond pulmonary involvement in coronavirus disease 2019 (COVID-19), a significant subset of patients experiences acute kidney injury. Patients who die from severe disease most notably show diffuse acute tubular injury on postmortem examination with a possible contribution of focal macro- and microvascular thrombi. Renal biopsies in patients with proteinuria and hematuria have demonstrated a glomerular dominant pattern of injury, most notably a collapsing glomerulopathy reminiscent of findings seen in human immunodeficiency virus (HIV) in individuals with apolipoprotein L-1 (APOL1) risk allele variants. Although various mechanisms have been proposed for the pathogenesis of acute kidney injury in SARS-CoV-2 infection, direct renal cell infection has not been definitively demonstrated and our understanding of the spectrum of renal involvement remains incomplete. Herein we discuss the biology, pathology, and pathogenesis of SARS-CoV-2 infection and associated renal involvement. We discuss the molecular biology, risk factors, and pathophysiology of renal injury associated with SARS-CoV-2 infection. We highlight the characteristics of specific renal pathologies based on native kidney biopsy and autopsy. Additionally, a brief discussion on ancillary studies and challenges in the diagnosis of SARS-CoV-2 is presented.

Generation and evaluation of a vaccine candidate of attenuated and heat-resistant genotype VIII Newcastle disease virus Impending Shortages of Kidney Replacement Therapy for COVID-19 Patients

Newcastle disease, which is a highly contagious and fatal disease caused by the Newcastle disease virus (NDV), has harmed the poultry industry for decades. The administration of effective vaccines can control most outbreaks and epidemics of Newcastle disease in the world. However, vaccination failures of live attenuated vaccines becasue of storage and transportation problems have been reported. Hence, thermostable live vaccine strains, such as V4 and I-2 strains, are being used and welcomed in tropical regions such as Africa and Southeast Asia. In this study, a thermostable, attenuated vaccine candidate strain NDV/rHR09 was generated using the genotype VIII heat-resistant virulent NDV strain HR09 by the reverse genetics system. The results of the determination of the mean death time and intracerebral pathogenicity index indicated that NDV/rHR09 is lentogenic even after 15 serial passages in embryonated chicken eggs. The thermostability assessment showed that the NDV/rHR09 strain exhibited hemagglutination activity and infectivity when exposed to 56°C for 60 min. Compared with the commercially available La Sota and V4 vaccines, the NDV/rHR09 induced higher antibody titers in specific pathogen-free chickens. In addition, NDV/rHR09 conferred complete protection against virulent genotype VII NDV challenge and virus shedding from vaccinated chickens. These results suggest that NDV/rHR09 is a promising thermostable vaccine candidate strain.