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COVID-19 and Kidney Disease: Update on Epidemiology, Clinical Manifestations, Pathophysiology and Management

Masoumeh Asgharpour1, Elham Zare2, Muhammed Mubarak3

  • 1Department of Nephrology, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|July 30, 2020
PubMed

Insights

Acute kidney injury (AKI) is common in critically ill coronavirus disease 2019 (COVID-19) patients, increasing mortality. Understanding SARS-CoV-2

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Acute kidney injury (AKI) is a frequent complication in critically ill coronavirus disease 2019 (COVID-19) patients.
  • AKI in COVID-19 is associated with increased mortality and prolonged hospital stays.
  • Kidney involvement often occurs in patients with severe acute respiratory distress syndrome (ARDS) or multiorgan failure.

Purpose of the Study:

  • To investigate the history, virology, epidemiology, clinical manifestations, pathophysiology, and management of COVID-19.
  • To explore the pathogenetic mechanisms of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2)-induced kidney damage.
  • To review the role of AKI as a risk factor for mortality in COVID-19 patients.

Main Methods:

  • Literature review using keywords such as SARS-CoV-2, COVID-19, renal impairment, sepsis, and viremia.
  • Publications were sourced from PubMed, Scopus, Google Scholar, and clinical trials registries.
  • Analysis of multifactorial causes of kidney damage in COVID-19.

Main Results:

  • COVID-19-induced kidney damage is multifactorial, including direct viral infection, sepsis, hemodynamic alterations, cytokine storm, and disseminated intravascular coagulation.
  • The angiotensin-converting enzyme 2 (ACE2) receptor, a SARS-CoV-2 entry point, is present in the kidneys.
  • Direct viral presence in kidney tissue is reported in few cases, necessitating further investigation.

Conclusions:

  • The exact mechanisms of kidney impairment in COVID-19 require further research.
  • Optimal management of AKI is crucial for improving outcomes in COVID-19 patients.
  • AKI is a significant risk factor for mortality in COVID-19.

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