ABSTRACT
Background: Kidney involvement in coronavirus disease 2019 (COVID-19) pathology has been supported by high frequency of angiotensin-converting enzyme 2 (ACE2) expression on renal cells and reports of acute kidney injury. However, the association between host viral load and kidney function is not clear. Aim: In this study, plasma levels of renal markers (urea nitrogen, creatinine, and estimated glomerular filtration rate (eGFR)) and electrolytes (sodium, potassium, chlorine, and bicarbonate) were assessed in relation to SARS-CoV-2 viral load of COVID-19 patients. Patients and Methods: This cross-sectional study involved 144 consenting COVID-19 patients admitted to the Ogun state COVID-19 isolation center between May and December 2020. All participants presented with mild respiratory symptoms and did not require ICU admission or ventilation support. Data included reverse transcriptase polymerase chain reaction (RT-PCR) cycle threshold (CT) value, blood urea nitrogen (BUN), creatinine, sodium, potassium, chlorine, bicarbonate measurements, and glomerular filtration rate. Reference intervals were used as comparators, and multiple linear regression model was fitted. Statistical significance was set at P < 0.05. Results: BUN level and creatinine were elevated in 4 (2.8%) and 42 (29.2%) patients, respectively, with lowered eGFR observed in 37 (25.7%) patients. Hyponatremia and hypokalemia were observed in 35 (24.3%) and 21 (14.6%) patients, respectively, while hypochloremia was observed in 21 (14.6%) patients. Lowered bicarbonate was observed in 29 (20.1%) patients. Linear regression showed statistically significant association (R2 = 0.340, P = 0.032) between RT-PCR CT value and eGFR (ß = 0.006, P = 0.017) as well as HCO3 (ß = -0.262, P = 0.036). Conclusion: COVID-19 patients with mild respiratory symptoms exhibited renal abnormalities, electrolytes, and acid-base imbalances which were partly associated with SARS-CoV-2 viral load.
Subject(s)
Acute Kidney Injury , COVID-19 , Humans , SARS-CoV-2 , Viral Load , Cross-Sectional Studies , Chlorine , Bicarbonates , CreatinineABSTRACT
COVID-19 caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) enters the host cells through attachment to the Angiotensin Converting Enzyme-2 receptors (ACE-2) on the host cells. ACE-2 is known to affect renal functions, vasoconstriction and fluid homeostasis. Thus, the impact of SARS-CoV-2 infection on renal functional parameters is worth investigating. Plasma obtained from whole blood samples collected from newly diagnosed COVID-19 patients were analysed for albumin, urea, creatinine, Na, K, Cl and HCO3 using auto analysers. All newly diagnosed patients were immediately admitted for managed at the Infectious Disease Center, Olodo in Ibadan the capital of Oyo State, South Western Nigeria. The results obtained were evaluated to determine the frequency of derangements in the renal parameters of patients with the COVID-19 disease. It was observed that 57.1%, 37.8%, 32.7%, 28.1%, 18.7%, 17.8% and 3.4% of newly diagnosed COVID-19 patients had values of Cl, creatinine, albumin, Na, K, HCO3 and urea respectively outside the reference ranges. While 43.3%, 4.7%, 2.5%, 2.5%, 2.0%, 1.7% and 1.0% of COVID-19 patients had values of Cl, creatinine, Na, K, albumin, Urea and HCO3 respectively above the reference ranges. Of all admitted patients, 33.1%, 30.7%, 25.6%, 16.8%, 16.3%, 13.8% and 1.7% had creatinine, albumin, Na, HCO3, K, Cl and urea values respectively below reference ranges. The changes in renal function parameters of newly diagnosed COVID-19 patients portend that renal failure is imminent in poorly managed COVID-19 patients and this has immunopathology implications during SAR-COV-2 infection.
ABSTRACT
The challenges associated with adequate deployment of nucleic acid amplification tests (NAATs) in developing countries underscores the important role of simple but sensitive and specific serological testing kits in COVID-19 diagnosis. Presently, there are a number of point-of-care tests for Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) screening. However, the reliability of these test kits is poorly documented and hence, needs to be ascertained. This study was therefore designed to determine the sensitivity and specificity of two serological test kits for COVID-19 screening with the view to providing necessary information on the suitability of their deployment as routine test kits for SARS-CoV-2 in Nigeria. Forty-seven (47) asymptomatic adults who had been tested for SARS-CoV-2 with the real-time reverse-transcriptase polymerase-chain reaction (RT-PCR) were enrolled into this study. Blood samples were obtained for qualitative determination of serum IgM and IgG antibodies to the S-antigen of SARS-CoV-2 using a commercially available IgM and IgG Rapid Diagnostic Test (RDT) and enzyme linked immunosorbent assay (ELISA). The association between the test kits (ELISA and RDT) and PCR in diagnosing COVID-19 was determined using the Fisher's Exact test at P<0.05. The sensitivity and specificity of the test kits were determined using ROC while the Positive Predictive Value (PPV), Negative Predictive Value (NPV), Positive Likelihood Ratio (PLR), Negative Likelihood Ratio (NLR), Diagnostic Odds Ratio (DOR) and accuracy were calculated as appropriate. Twenty-eight (59.6%) of the study participants had positive PCR result. ELISA and RDT identified 20 (42.6%) and 13 (27.7%) participants respectively as having anti- SARS COV-2 specific antibodies. ELISA had a better sensitivity performance, NPV, PLR, DOR and accuracy than the RDT while the RDT had a better specificity performance than ELISA. The proportion of participants with anti-SARS-CoV-2 IgM antibody identified using ELISA was significantly higher compared with RDT. In contrast, the proportion of participants with positive anti- SARS COV-2 IgG antibody identified using RDT was significantly higher compared with ELISA. ELISA has a better sensitivity for detecting anti-SARS-CoV-2 Spike-protein specific antibodies than the RDT. However, combination of RDT and ELISA for the detection of anti-SARS-COV-2 antibodies might be useful for population COVID-19 screening.