Renal function dynamics in COVID-19: exploring biomarker interactions with D-dimer and C-reactive proteins.

Area of Science:

• Nephrology
• Infectious Diseases
• Biochemistry

Background:

• COVID-19 primarily affects the respiratory system but can impact kidneys due to ACE2 receptor expression.
• Acute kidney injury (AKI) is an emerging complication of SARS-CoV-2 infection.
• Kidney involvement in COVID-19 necessitates understanding the relationship between disease severity and renal function.

Purpose of the Study:

• To investigate the association between COVID-19 severity and renal function abnormalities.
• To analyze key biochemical markers including BUN, creatinine, BUN/Cr ratio, and eGFR in relation to inflammatory markers.
• To explore the underlying mechanisms of kidney injury in COVID-19.

Main Methods:

• Retrospective analysis of biochemical parameters (BUN, Cr, BUN/Cr, eGFR) and inflammatory markers (CRP, D-dimer).
• Descriptive statistics and Joint Generalized Linear Models were used to analyze data.
• In-silico studies were conducted to investigate AKI-associated pathways.

Main Results:

• Significant positive correlation found between serum urea levels and CRP/D-dimer, indicating heightened inflammation.
• Estimated glomerular filtration rate (eGFR) positively associated with CRP, suggesting renal involvement in systemic inflammation.
• Serum creatinine showed no significant association with CRP or D-dimer, potentially due to lower sensitivity in early stages.

Conclusions:

• Elevated urea and decreased eGFR in COVID-19 patients may indicate increased inflammation and kidney injury.
• In-silico findings support pathways like IL-6/JAK-STAT, NF-κB, HIF-1, and complement in COVID-19-related AKI.
• Monitoring renal function parameters is vital for assessing COVID-19 progression and potential complications.