The Investigation of Kidney Involvement in 430 Hospitalized Patients with Omicron COVID-19 in Tianjin, China.

INTRODUCTION: This study evaluated the incidence, clinical characteristics, and risk factors of kidney involvement in patients with the Omicron variant infection in the post-acute treatment phase in Tianjin, China. METHODS: Data were collected from 430 patients with Omicron variant infection in Tianjin, China. Demographics, comorbidities, laboratory blood tests, urinalysis, vaccination status, and COVID-19 clinical classification were assessed. Patients were grouped based on kidney involvement, and associated risk factors of kidney involvement were also investigated. RESULTS: Asymptomatic, mild, ordinary, and severe patients with Omicron COVID-19 variant comprised 1.5%, 49.1%, 48.9%, and 0.5% of the sample population, respectively, without critical illness or death. The incidences of hematuria, proteinuria, and concurrent hematuria and proteinuria were 14.7%, 14.2%, and 5.1%, respectively. Patients with and without kidney involvement differed in age, body mass index (BMI), comorbidity, creatinine levels, estimated glomerular filtration rate, and C-reactive protein (CRP) levels. Age, hypertension, higher CRP levels, and higher BMI were linked with kidney involvement. CONCLUSION: The majority of the patients suffered from mild or ordinary symptoms of Omicron COVID-19 infection. The primary kidney involvement was hematuria and proteinuria. Proteinuria was significantly associated with Omicron variant infection, and patients with hypertensive comorbidity, higher CRP, and higher creatinine levels were at increased risk of proteinuria after Omicron variant infection.

COVID-19 in patients with and without acute kidney injury.

BACKGROUND AND OBJECTIVE: SARS-CoV-2 as the newest member of Beta-Coronaviruses can cause a complicated disease called COVID-19. This virus is able to penetrate a broad range of human cells, such as liver, heart, and kidney cells via ACE2-associated endocytosis. Heart involvement can result in kidney injuries; it is now testified that kidney congestion occurs following the cardio-renal syndrome. Acute Kidney Injury is one of the most critical damages to the kidney in a wide range of COVID-19-caused kidney injuries (which includes proteinuria, hematuria, etc.). Examination of AKI risk factors in COVID-19 patients can assist physicians to prevent its incidence. The final aim of this systematic review was to collate the condition and risk factors of AKI and non-AKI COVID-19 patients and to investigate AKI incidence in high-risk patients. METHOD: A complete and comprehensive survey was performed by reviewing original articles and case reports indexed in various databases such as PubMed/Medline, Embase, and WoS to find appropriate articles. The eligible articles then were selected by two authors and entered into the evaluation process. This systematic review conforms PRISMA statement. RESULTS: After searching for potentially relevant articles, 14 out of the initial 463 articles from 6 countries were selected and evaluated. All of eligible articles have investigated the rate of AKI incidence and its physio-pathological consequences in COVID-19 patients in all conditions (not only patients in critical condition). First, the initial differences between AKI and non-AKI patients were compared. As an instance, our study revealed that mean of White Blood cells (WBC) was much higher in AKI patients which can be responsible for the severe conditions. Then, other variations like differences in laboratory and imaging findings were compared between these two groups. Our outcomes demonstrated that the presence of diabetes mellitus (DM), hypertension (HTN), and male sex can be three significant risk factors in AKI incidence in COVID-19 patients. Fatality rate and treatment methods were also compared among these two groups. CONCLUSION: As one of kidney damages, AKI can worsen COVID-19 patients' status by causing conditions such as acidosis. Our study shows the common symptoms in AKI COVID-19 patients were fever, cough, and malaise. The results of our study can help physicians to arrange COVID-19 with AKI patients' treatment strategy precisely (Tab. 8, Fig. 1, Ref. 48).

Early creatinine and e-GFR changes as prognostic predictors of COVID-19 patients

We aimed to investigate the effects of the COVID-19 disease on kidney functions and early prognosis.All cases were divided into those discharged and exitus cases. The patients were diagnosed with acute kidney injury (AKI) according to the KDIGO criteria.As a result of the ROC analysis, the patients with a creatinine value above 1.05 for day 1 and 0.975 for creatinine value on day 7 would be mortal (AUC values of 0.641 (0.569–0.714) and 0.757 (0.689–0.825), respectively). As a result of Univariate analysis;D-Dimer, Procalcitonin, BUN and creatinine values are risk factors and a one-unit increase in these values is 1.184;1.105;It was determined that it would increase 1.024 and 1.304 times (p values 0.008;0.007;<0.001;0.002), respectively. Decreased in e-GFR value would increase the risk of death 1.026 (1/0.975) times (p<0.001).We observed the high creatinine, D-dimer, procalcitonin, ferritin, and low e-GFR levels were risk factors for severity and mortality for COVID-19 disease. While physicians and all stakeholders focus on the prognosis and mortality of the disease of COVID-19 disease, it is necessary to be thorough about kidney involvement as much as respiratory system involvement. (English) [ FROM AUTHOR] Biz bu çalışmada COVÍD-19 pandemisinin böbrek fonksiyonları üzerine etkilerini ve erken dönem prognozunu araştırmayı amaçladık.Tüm olgular,taburcu olanlar ve exitus olanlar şeklinde ikiye ayrılmıştır. Hastalarda akut böbrek hasarı (ABH) tanısı KDIGO kriterlerine göre konmuştur.ROC analizi sonucunda;1. gün kreatinine değeri için 1.05 üzeri ve 7. gün kreatinine değeri için de 0.975 üzeri olanlarda mortal seyredeceği tespit edilmiştir (AUC değerleri sırasıyla 0.641 (0.569–0.714) ve 0.757 (0.689–0.825)). Univariate analiz sonucunda ise;D-Dimer, Procalcitonin, BUN ve kreatinin değerlerinin risk faktörü olduğu ve bu değerlerde meydana gelecek olan bir birimlik artışın ölüm riskini sırasıyla 1,184;1,105;1,024 ve 1,304 kat artıracağı tespit edilmiştir (p değerleri sırasıyla 0.008;0.007;<0.001;0.002). e-GFR değerindeki azalış ise ölüm riskini 1,026 (1/0.975) kat artıracağı tespit edilmiştir (p<0.001).COVID-19 hastalığında yüksek kreatinin, D-dimer, prokalsitonin, ferritin ve düşük e-GFR düzeylerinin hastalık şiddeti ve mortalite üzerinde risk faktörü olduğunu tespit ettik. COVÍD-19 hastalığında hekimlerin ve tüm paydaşların hastalığın prognoz ve mortalitesi üzerinde yoğunlaşırken böbrek tutulumu konusunda da en az solunum sistemi tutulumu kadar titiz olması gereklidir. (Turkish) [ FROM AUTHOR] Copyright of Turkish Journal of Biochemistry / Turk Biyokimya Dergisi is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

COVID-19 and renal involvement in children: a retrospective study.

Background: The New coronavirus (SARS COV-2) can cause acute respiratory disease and also multiorgan dysfunction. There is insufficient data about kidney involvement in children. So, this study was done on children with COVID-19 to evaluate nephrological involvement. Methods: All children with confirmed or suspected COVID-19 who were admitted in Children Hospital .were enrolled. They were admitted in hospital from March 2020 to July 2020. Serum Blood Urea Nitrogen (BUN), creatinine, sodium, potassium, calcium and urinalysis were evaluated. Also, glomerular filtration rate (GFR) was calculated by Schertz's formula. All patients were evaluated by chest x-ray and/or computerized tomography scanning (CTS). The data were analyzed by SPSS software and P value less than 0.05 was determined as significant. Results: Forty-seven children with confirmed or suspected COVID-19 were enrolled to this study. At admission, 23.4% and 27.7% of children with COVID-19 infection had abnormal increase in serum BUN and creatinine, respectively. Also 78.8% and 25.5% of children had GFR less than 90 and 60 ml/min /1.732, respectively. Additionally, 13/47 (27.7%) of children had abnormal urine analysis (microscopic hematuria and/or proteinuria). There wasn't a significant relationship between pulmonary lesions and abnormal reduction of GFR (P<0/05). Conclusion: In the study, the risk of AKI (acute kidney injury) and decrease of GFR and also abnormal urinalysis is high in children with COVID-19. So, more attention for detection of kidney involvement is necessary and more conservative management for prevention of AKI and decrease of GFR are recommended.

Proteinuria as a Biomarker for COVID-19 Severity.

BACKGROUND: Renal involvement in syndrome coronavirus 2 (SARS-CoV-2) infection has been retrospectively described, especially acute kidney injury (AKI). However, quantitative proteinuria assessment and its implication in coronavirus disease 2019 (COVID-19) remain unknown. METHODS: In this prospective, multicenter study in France, we collected clinical and biological data including urinary protein to creatine ratio (UPCR) in patients presenting with moderate to severe COVID-19. Clinical outcome was analyzed according to the level of UPCR. RESULTS: 42/45 patients (93.3%) had renal involvement (abnormal urinary sediment and/or AKI). Significant proteinuria occurred in 60% of patients. Urine protein electrophoresis showed tubular protein excretion in 83.8% of patients with proteinuria. Inflammatory parametersand D-dimer concentrations correlated with proteinuria level. Patients who required intensive care unit (ICU) admission had higher proteinuria (p = 0.008). On multivariate analysis, proteinuria greater than 0.3 g/g was related to a higher prevalence of ICU admission [OR = 4.72, IC95 (1.16-23.21), p = 0.03], acute respiratory distress syndrome (ARDS) [OR = 6.89, IC95 (1.41-53.01, p = 0.02)], nosocomial infections [OR = 3.75, IC95 (1.11-13.55), p = 0.03], longer inpatient hospital stay (p = 0.003). CONCLUSION: Renal involvement is common in moderate to severe SARS-CoV-2 infection. Proteinuria at baseline is an independent risk factor for increased hospitalization duration and ICU admission in patients with COVID-19.