Patterns of Recovery of Kidney Function in Patients with Covid-19 and Acute Kidney Injury in a Reference Center in Mexico

Introduction: La enfermedad renal por COVID-19 es clara, sin embargo, hay pocos datos sobre los resultados renales en pacientes que desarrollaron esta enfermedad. Method(s): El objetivo del estudio fue identificar los factores asociados con la lesion renal aguda, los patrones de recuperacion de la funcion renal, la enfermedad renal aguda, la enfermedad renal cronica post-COVID-19 y la muerte. Cohorte retrospectiva realizada en el Hospital de Especialidades del Centro Medico Nacional ''La Raza" en Mexico. Se incluyeron 204 pacientes hospitalizados de marzo a junio de 2020 por COVID-19. Las variables cuantitativas se expresan como media +/- desviacion estandar. Se calcularon razones de momios para identificar factores asociados, con un intervalo de confianza del 95%. Result(s): La edad media fue de 57,83+/-15,42 anos. La incidencia de FRA fue del 42,2% (86 casos). En general, el 31,4% (27 casos) y el 12,8% (11 casos) tuvieron un patron de recuperacion de la funcion renal temprana y tardia, respectivamente, y el 55,8% (48 casos) no se recupero. AKD desarrollo en el 19,8% (17 casos), de los cuales los estadios 0, 1, 2 y 3 se observaron en el 4,7% (4 casos), 1,2% (1 casos), 3,5% (3 casos) y 12,8% (11 casos) respectivamente. Se completo un seguimiento de al menos 12 meses de 98 casos, de los cuales el 9,2% (9 casos) desarrollaron algun estadio de ERC. En estadio G3a, G4, G5 con terapia de reemplazo renal en 4,1% (4 casos), 1% (1 caso), 4,1% (4 casos) respectivamente. Los factores asociados a FRA fueron edad > 60 anos (OR: 3,48;IC: 1,94 - 6,26), hipertension arterial (OR: 2,56;IC: 1,44 - 4,54), uso de vasopresor (OR: 6,68;IC: 3,40 - 13,13), uso de ventilacion mecanica (OR: 6,71;IC: 3,61 - 12,45), forma grave de COVID-19 (OR: 3,95;IC: 1,72 - 9,05), trombocitopenia leve (OR: 3,07;IC: 1,10 - 8,54), SOFA > 4 puntos (OR: 6,22;IC: 3,32 - 11,62), uso de lopinavir/ritonavir en hospitalizacion (OR: 3,94;IC: 1,46 - 10,64), uso de antagonista del receptor de angiotensina II en hospitalizacion (OR: 3,13;IC: 1,49 - 6,58). Los factores asociados con la ERCA fueron el uso de vasopresores (OR: 9,68, IC: 3,01 - 31,14), ventilacion mecanica (OR: 4,85, IC: 1,52 - 15,45), trombocitopenia leve (OR: 5,55, IC: 1,69 - 18,15) y uso de antagonista del receptor de angiotensina II (OR: 3,66;IC: 1,29 - 10-38). Los factores asociados a la ERC fueron el uso de vasopresores (OR: 1,81, IC: 1,50 - 2,19) y el uso de lopinavir/ritonavir (OR: 1,13, IC: 1,04 - 1,21). En pacientes con LRA asociada a COVID-19 se observo una mortalidad del 65,1%. Se concedio terapia de reemplazo renal a 10. Conclusion(s): La insuficiencia renal aguda es una complicacion frecuente en pacientes con COVID-19, con factores de riesgo implicados en su desarrollo, asi como en su evolucion a enfermedad renal aguda o enfermedad renal cronica. La severidad de la LRA con necesidad de TRS es un factor de riesgo de mortalidad como ha sido reportado en otra bibliografia. No conflict of interestCopyright © 2023

Seafood safety and food‐borne zoonoses from fish

Parasitic nematodes of the genus Anisakis are the causative agent of anisakiosis, an important fish‐borne zoonosis. Humans are infected through consumption of raw or undercooked fish, contaminated with the parasite. Infection can result in both gastrointestinal and allergic symptoms. There are few reports of anisakiosis in Portugal, but evidence of Anisakis allergy exists, indicating that exposure is occurring in the population. The European Food Risk Assessment Fellowship Programme (EU‐FORA) work programme, entitled: ‘Food safety of fish and zoonoses: fish consumption and microbiological risk assessment and perception, from fisherman to final consumers in Portugal’ was hosted by the Interdisciplinary Centre of Marine and Environmental Research (CIIMAR), in Porto, Portugal. It aimed to gather information on risk perception and attitudes in the Portuguese population to contamination of fish with Anisakis spp. and on their knowledge of methods to prevent infection. In addition, it aimed to examine the risk of anisakiosis in the Portuguese population.

The relevance of urinalysis in the hospitalization of patients with COVID-19 and nephrology early intervention

Background: Multidisciplinary management of the COVID's patients is essential for their evolution, and the early detection ok AKI is a important role to avoid morbimortality. In March 2020, the pandemic by COVID-19 appeared in Mexico, and it led all the health system to change the intrahospital management. Methods: In a retrospective, observational analysis of all the patients >18 Y that were hospitalized at the Hospital Universitario de Monterrey, in the COVID area, from March to August 2020, we notice how the urinary sedimentation evaluation from the beginning could detect patients who could develop AKI or the need of RRT. All data were analyzed using SPSS statistical software (version 25;IBM Corporation, Armonk, New York). Results: A total of 344 patients hospitalized from March to August 2020. 220 patients with EGO since the beginning (obtained when our nephrology team take place on the presential participation on AEMA) 102 did not have proteinuria, and, on the other hand, the rest (61 or 37%) reported it. 95 patients (41.7%) had hematuria. Hematuria were more likely to be treated with KRT. Patients with hematuria demonstrated an increased tendency to require RRT: 38.2% of patients with hematuria versus 11.6% without hematuria, the greater chance that needs RRT (P<.001). Conclusions: The presence of active sedimentary urinary on COVID patients is frequent. The patients who present the combination of hematuria and proteinuria develop severe AKI (KDIGO 3 without RRT) or the need for RRT. Factors in patients such as to be on their upper edge of 40 years old, the presence of hyperkalemia, metabolic acidosis, also the hematuria and proteinuria, suggest the AKI risk that required RRT.

Pulmonary evaluation of post-COVID-19 patients: An ecuadorian experience

Rationale: COVID-19 is a disease that can have many clinical manifestations, affecting systems such as the respiratory system. Some patients could have long-term sequelae. The aim of this study is to describe the results obtained in the lung function tests and questionnaires carried out on post-COVID-19 patients. Methods: This is a cross-sectional study of patients who had COVID-19 and were attended between May to December 2020. Patients were evaluated by: pre/post bronchodilator spirometry, DLCO, 6MWT, SNIP, PImax, questionnaires to assess anxiety/depression (HADS and GAD-7) and related to the symptoms of COVID-19. The variables were described according to their type and distribution. Results: Sixty-three patients were included. Fifty-six percent of the patients were men with an average of 53 years old (SD:14). In the spirometry probable restriction by FVC/LLN was observed in 33% of the patients. Fifty-six patients performed the test of the diffusing capacity of the lungs for carbon monoxide, 34% had a decrease value. The patients who had a decrease in DLCO associated with a probable restriction were 23%. However, up to 20% of the patients who had a decrease in DLCO, the FVC was normal.In relation to the other tests and questionnaires carried out, the results were: for muscle weakness (SNIP and PImax) 33,3% and 16%, respectively;for anxiety (HADS and GAD-7) 19% and 15%, respectively, and 2% had depression. Finally, the 6MWT was completed by the 89% of patients, with a global performance of 72% (IQR:58-81).Information related to symptoms and comorbidities could be obtained from 38 patients. During the medical consultation, 46% had persistence of symptoms (median: 77 days;IQR:40-168). The initial symptoms, most common, were fever (21%), sore throat (16%), dyspnea and general malaise (11%). Besides, the most persistent symptoms were fatigue (29%), dyspnea (16%), anosmia (13%) and chest tightness (11%). About 61% of the patients had at least 1 comorbidity, the 4 most frequent being obesity (32%), hypertension (29%), arthrosis (16%) and diabetes (13%). Conclusion: The evaluation of post-COVID-19 patients should have included questionnaires that assess mental health and lung function test (spirometry, DLCO, PImax and 6MWT). Some patients with normal spirometry could have decrease DLCO, for instance is important to include DLCO test in all these patients.