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Kozłowski P, Leszczyńska A, Ciepiela O. Long COVID Definition, Symptoms, Risk Factors, Epidemiology and Autoimmunity: A Narrative Review. AMERICAN JOURNAL OF MEDICINE OPEN 2024; 11:100068. [PMID: 39034937 PMCID: PMC11256271 DOI: 10.1016/j.ajmo.2024.100068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 07/23/2024]
Abstract
The virus called SARS-CoV-2 emerged in 2019 and quickly spread worldwide, causing COVID-19. It has greatly impacted on everyday life, healthcare systems, and the global economy. In order to save as many lives as possible, precautions such as social distancing, quarantine, and testing policies were implemented, and effective vaccines were developed. A growing amount of data collected worldwide allowed the characterization of this new disease, which turned out to be more complex than other common respiratory tract infections. An increasing number of convalescents presented with a variety of nonspecific symptoms emerging after the acute infection. This possible new global health problem was identified and labelled as long COVID. Since then, a great effort has been made by clinicians and the scientific community to understand the underlying mechanisms and to develop preventive measures and effective treatment. The role of autoimmunity induced by SARS-CoV-2 infection in the development of long COVID is discussed in this review. We aim to deliver a description of several conditions with an autoimmune background observed in COVID-19 convalescents, including Guillain-Barré syndrome, antiphospholipid syndrome and related thrombosis, and Kawasaki disease highlighting a relationship between SARS-CoV-2 infection and the development of autoimmunity. However, further studies are required to determine its true clinical significance.
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Affiliation(s)
- Paweł Kozłowski
- Central Laboratory, University Clinical Centre of the Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Leszczyńska
- Central Laboratory, University Clinical Centre of the Medical University of Warsaw, Warsaw, Poland
| | - Olga Ciepiela
- Central Laboratory, University Clinical Centre of the Medical University of Warsaw, Warsaw, Poland
- Department of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland
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2
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Altoukhi SM, Zamkah MM, Alharbi RA, Alghamdi SK, Aldawsari LS, Tarabulsi M, Rizk H, Sandokji Y. Understanding the effects of COVID-19 on patients with diabetic nephropathy: a systematic review. Ann Med Surg (Lond) 2024; 86:3478-3486. [PMID: 38846830 PMCID: PMC11152851 DOI: 10.1097/ms9.0000000000002053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/30/2024] [Indexed: 06/09/2024] Open
Abstract
Background Diabetic nephropathy is one of the consequences of diabetes mellitus that causes a continuous decline in the eGFR. After the COVID-19 pandemic, studies have shown that patients with diabetic nephropathy who had contracted COVID-19 have higher rates of morbidity and disease progression. The aim of this study was to systematically review the literature to determine and understand the effects and complications of SARS-CoV-2 on patients with diabetic nephropathy. Materials and methods The authors' research protocol encompassed the study selection process, search strategy, inclusion/exclusion criteria, and a data extraction plan. A systematic review was conducted by a team of five reviewers, with an additional reviewer assigned to address any discrepancies. To ensure comprehensive coverage, the authors employed multiple search engines including PubMed, ResearchGate, ScienceDirect, SDL, Ovid, and Google Scholar. Results A total of 14 articles meeting the inclusion criteria revealed that COVID-19 directly affects the kidneys by utilizing ACE2 receptors for cell entry, which is significant because ACE2 receptors are widely expressed in the kidney. Conclusion COVID-19 affects kidney health, especially in individuals with diabetic nephropathy. The mechanisms include direct viral infection and immune-mediated injury. Early recognition and management are vital for improving the outcomes.
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Affiliation(s)
| | | | | | | | | | | | - Hisham Rizk
- General Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Yousif Sandokji
- General Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
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Tannor EK, Davidson B, Nlandu Y, Bagasha P, Bilchut WH, Davids MR, Diongole HM, Ekrikpo UE, Hafiz EO, Ibrahim KS, Kalyesubula R, Nalado AM, Olanrewaju TO, Onu UC, Pereira-Kamath N, Sakajiki AM, Salah M, Vincent L, Arruebo S, Bello AK, Caskey FJ, Damster S, Donner JA, Jha V, Johnson DW, Levin A, Malik C, Nangaku M, Okpechi IG, Tonelli M, Ye F, Ashuntantang GE, Arogundade FA. Capacity for the management of kidney failure in the International Society of Nephrology Africa region: report from the 2023 ISN Global Kidney Atlas (ISN-GKHA). Kidney Int Suppl (2011) 2024; 13:12-28. [PMID: 38618494 PMCID: PMC11010621 DOI: 10.1016/j.kisu.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 04/16/2024] Open
Abstract
The burden of chronic kidney disease and associated risk of kidney failure are increasing in Africa. The management of people with chronic kidney disease is fraught with numerous challenges because of limitations in health systems and infrastructures for care delivery. From the third iteration of the International Society of Nephrology Global Kidney Health Atlas, we describe the status of kidney care in the ISN Africa region using the World Health Organization building blocks for health systems. We identified limited government health spending, which in turn led to increased out-of-pocket costs for people with kidney disease at the point of service delivery. The health care workforce across Africa was suboptimal and further challenged by the exodus of trained health care workers out of the continent. Medical products, technologies, and services for the management of people with nondialysis chronic kidney disease and for kidney replacement therapy were scarce due to limitations in health infrastructure, which was inequitably distributed. There were few kidney registries and advocacy groups championing kidney disease management in Africa compared with the rest of the world. Strategies for ensuring improved kidney care in Africa include focusing on chronic kidney disease prevention and early detection, improving the effectiveness of the available health care workforce (e.g., multidisciplinary teams, task substitution, and telemedicine), augmenting kidney care financing, providing quality, up-to-date health information data, and improving the accessibility, affordability, and delivery of quality treatment (kidney replacement therapy or conservative kidney management) for all people living with kidney failure.
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Affiliation(s)
- Elliot Koranteng Tannor
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Renal Unit, Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Bianca Davidson
- Division of Nephrology and Hypertension, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Yannick Nlandu
- Nephrology Unit, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Peace Bagasha
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
- Directorate of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda
| | | | - M. Razeen Davids
- Division of Nephrology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Hassane M. Diongole
- Division of Nephrology, Department of Medicine, National Hospital Zinder, Zinder, Niger
- Faculty of Health Sciences, University of Zinder, Zinder, Niger
| | - Udeme E. Ekrikpo
- Department of Medicine, University of Uyo/University of Uyo Teaching Hospital, Uyo, Nigeria
| | - Ehab O.A. Hafiz
- Electron Microscopy Department, Clinical Laboratory Division, Theodor Bilharz Research Institute, Giza, Egypt
| | - Kwaifa Salihu Ibrahim
- Nephrology Unit, Department of Medicine, Wuse District Hospital, Abuja, Nigeria
- Department of Internal Medicine, College of Health Sciences, Nile University, Federal Capital Territory, Abuja, Nigeria
| | - Robert Kalyesubula
- Department of Physiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Aisha M. Nalado
- Department of Medicine, Bayero University Kano, Kano, Nigeria
| | - Timothy O. Olanrewaju
- Division of Nephrology, Department of Medicine, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Ugochi Chika Onu
- Renal Unit, Department of Medicine, University of Nigeria Teaching Hospital, ItukuOzalla, Enugu State, Nigeria
| | | | - Aminu Muhammad Sakajiki
- Department of Medicine, Usmanu Danfodiyo University and Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Mohamed Salah
- National Institute of Urology & Nephrology, Cairo, Egypt
| | | | - Silvia Arruebo
- The International Society of Nephrology, Brussels, Belgium
| | - Aminu K. Bello
- Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Fergus J. Caskey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Jo-Ann Donner
- The International Society of Nephrology, Brussels, Belgium
| | - Vivekanand Jha
- George Institute for Global Health, University of New South Wales (UNSW), New Delhi, India
- School of Public Health, Imperial College, London, UK
- Manipal Academy of Higher Education, Manipal, India
| | - David W. Johnson
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Australasian Kidney Trials Network at the University of Queensland, Brisbane, Queensland, Australia
| | - Adeera Levin
- Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charu Malik
- The International Society of Nephrology, Brussels, Belgium
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Ikechi G. Okpechi
- Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa
- Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Canada and Pan-American Health Organization/World Health Organization’s Collaborating Centre in Prevention and Control of Chronic Kidney Disease, University of Calgary, Calgary, Alberta, Canada
| | - Feng Ye
- Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Gloria Enow Ashuntantang
- Faculty of Medicine and Biomedical Sciences, Yaounde General Hospital, University of Yaounde I, Yaounde, Cameroon
| | - Fatiu Abiola Arogundade
- Renal Unit, Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Tang Q, Xie X, Peng L, Yang L, Chen Y, Yu S. Preexisting renal graft dysfunction as a major risk factor for SARS-CoV-2 Omicron variant pneumonia: A postinfection cross-sectional study of 312 immunosuppressed renal transplant recipients. Int J Infect Dis 2024; 141:106962. [PMID: 38360204 DOI: 10.1016/j.ijid.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVES SARS-CoV-2 pneumonia poses significant challenges to health systems worldwide, particularly, in severe and critical cases. Immunosuppressed renal transplant recipients appear to be at a particularly high risk for severe or critical COVID-19 illness. However, few studies elucidated the risk factors of SARS-CoV-2 pneumonia in renal transplant recipients with COVID-19. METHODS A postinfection cross-sectional survey was conducted in 312 renal transplant recipients and 503 age- and sex-matched controls to explore risk factors for SARS-CoV-2 pneumonia in immunosuppressed renal transplant recipients. RESULTS The results showed that renal transplant recipients had a much higher incidence of SARS-CoV-2 pneumonia (48.1%) after infection with the SARS-CoV-2 Omicron variant than controls (5.6%). The multivariate binary logistic regression analysis identified older age, lower creatinine clearance before infection, and higher dose of prednisone before infection as risk factors for SARS-CoV-2 pneumonia in renal transplant recipients. Preexisting renal dysfunction was a major risk factor for SARS-CoV-2 pneumonia, with an odds ratio of 3.27 (1.01-10.61). CONCLUSIONS Preexisting renal graft dysfunction was a major risk factor for SARS-CoV-2 Omicron variant pneumonia. It is suggested that high-risk renal transplant recipients should undergo computed tomography scanning within 14 days after infection with SARS-CoV-2.
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Affiliation(s)
- Qi Tang
- Department of Rheumatology and Immunology, the Second Xiangya Hospital, Central South University, Changsha, China; Clinical Medical Research Center for Systemic Autoimmune Diseases in Hunan Province, Changsha, China
| | - Xubiao Xie
- Department of Renal Transplantation, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Longkai Peng
- Department of Renal Transplantation, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Linxin Yang
- Department of Rheumatology and Immunology, the Second Xiangya Hospital, Central South University, Changsha, China; Clinical Medical Research Center for Systemic Autoimmune Diseases in Hunan Province, Changsha, China
| | - Yubin Chen
- Department of Rheumatology and Immunology, the Second Xiangya Hospital, Central South University, Changsha, China; Clinical Medical Research Center for Systemic Autoimmune Diseases in Hunan Province, Changsha, China
| | - Shaojie Yu
- Department of Renal Transplantation, the Second Xiangya Hospital, Central South University, Changsha, China.
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Hye MA, Biswas MHA, Uddin MF, Rahman MM. A mathematical model for the transmission of co-infection with COVID-19 and kidney disease. Sci Rep 2024; 14:5680. [PMID: 38454115 PMCID: PMC10920798 DOI: 10.1038/s41598-024-56399-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/06/2024] [Indexed: 03/09/2024] Open
Abstract
The world suffers from the acute respiratory syndrome COVID-19 pandemic, which will be scary if other co-existing illnesses exacerbate it. The co-occurrence of the COVID-19 virus with kidney disease has not been available in the literature. So, further research needs to be conducted to reveal the transmission dynamics of COVID-19 and kidney disease. This study aims to create mathematical models to understand how COVID-19 interacts with kidney diseases in specific populations. Therefore, the initial step was to formulate a deterministic Susceptible-Infected-Recovered (SIR) mathematical model to depict the co-infection dynamics of COVID-19 and kidney disease. A mathematical model with seven compartments has been developed using nonlinear ordinary differential equations. This model incorporates the invariant region, disease-free and endemic equilibrium, along with the positivity solution. The basic reproduction number, calculated via the next-generation matrix, allows us to assess the stability of the equilibrium. Sensitivity analysis is also utilised to understand the influence of each parameter on disease spread or containment. The results show that a surge in COVID-19 infection rates and the existence of kidney disease significantly enhances the co-infection risks. Numerical simulations further clarify the potential outcomes of treating COVID-19 alone, kidney disease alone, and co-infected cases. The study of the potential model can be utilised to maximise the benefits of simulation to minimise the global health complexity of COVID-19 and kidney disease.
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Affiliation(s)
- Md Abdul Hye
- Department of Mathematics and Statistics, Bangladesh University of Business and Technology (BUBT), Dhaka, 1216, Bangladesh.
- Department of Mathematics, Bangladesh University of Engineering and Technology (BUET), Dhaka, 1000, Bangladesh.
| | | | - Mohammed Forhad Uddin
- Department of Mathematics, Bangladesh University of Engineering and Technology (BUET), Dhaka, 1000, Bangladesh.
| | - Md M Rahman
- Department of Mathematics, Faculty of Science, Islamic University, Kushtia, 7003, Bangladesh.
- School of Engineering, Design and Built Environment, Western Sydney University, Penrith, NSW, 2751, Australia.
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Yin J, Wang Y, Jiang H, Wu C, Sang Z, Sun W, Wei J, Wang W, Liu D, Huang H. Blood urea nitrogen and clinical prognosis in patients with COVID-19: A retrospective study. Medicine (Baltimore) 2024; 103:e37299. [PMID: 38394490 PMCID: PMC10883624 DOI: 10.1097/md.0000000000037299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
The aim of this study was to estimate the association between blood urea nitrogen (BUN) and clinical prognosis in patients with COVID-19. A multicenter, retrospective study was conducted in adult patients with COVID-19 in 3 hospitals in Zhenjiang from January 2023 to May 2023. Patients were divided into survival and death group based on whether they survived at day 28. The demographic, comorbidities, and laboratory data were independently collected and analyzed, as well as clinical outcomes. Total 141 patients were enrolled and 23 (16.3%) died within 28 days. Patients who died within 28 days had a higher level of BUN compared with survivors. Bivariate logistic regression analysis showed that BUN was a risk factor for 28-day mortality in patients with COVID-19. ROC curve showed that BUN could predict 28-day mortality of COVID-19 patients (AUC = 0.796, 95%CI: 0.654-0.938, P < .001). When the cutoff value of BUN was 7.37 mmol/L, the sensitivity and specificity were 84.62% and 70.31%. Subgroup analysis demonstrated that hyper-BUN (≥7.37 mmol/L) was associated with increased 28-day mortality among COVID-19 patients. Patients with COVID-19 who died within 28 days had a higher level of BUN, and hyper-BUN (≥7.37 mmol/L) was associated with increased 28-day mortality.
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Affiliation(s)
- Jiangtao Yin
- Department of Critical Care Medicine, Digestive Disease Institute of Jiangsu University, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Yuchao Wang
- Medical School of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Hongyan Jiang
- Department of Cardiology, Danyang People’s Hospital, Zhenjiang, People’s Republic of China
| | - Caixia Wu
- Medical School of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Ziyi Sang
- Medical School of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Wen Sun
- Department of Critical Care Medicine, Jurong Hospital Affiliated to Jiangsu University, Zhenjiang, People’s Republic of China
| | - Junfei Wei
- Department of Critical Care Medicine, Traditional Chinese Medicine Hospital of Zhenjiang, Zhenjiang, People’s Republic of China
| | - Wenli Wang
- Department of Critical Care Medicine, Digestive Disease Institute of Jiangsu University, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Dadong Liu
- Department of Critical Care Medicine, Digestive Disease Institute of Jiangsu University, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
- Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Hanpeng Huang
- Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
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Cheruiyot S, Shabani J, Shah J, Gathu C, Sokwala A. Associated Factors and Outcomes of Acute Kidney Injury in COVID-19 Patients in Kenya. Can J Kidney Health Dis 2024; 11:20543581241227015. [PMID: 38292818 PMCID: PMC10826382 DOI: 10.1177/20543581241227015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
Background Corona Virus Disease 2019 (COVID-19), an infection caused by the SARS-CoV-2 virus, has been the largest global pandemic since the turn of the 21st century. With emerging research on this novel virus, studies from the African continent have been few. Corona Virus Disease 2019 has been shown to affect various organs including the lungs, gut, nervous system, and the kidneys. Acute kidney injury (AKI) is an independent risk factor for mortality and increases the health care burden for patients with persistent kidney dysfunction and maintenance dialysis. Sub-Saharan Africa has a high number of poorly controlled chronic illnesses, economic inequalities, and health system strains that may contribute to higher cases of kidney injury in patients with COVID-19 disease. Objectives The objective of this study was to determine the incidence, associated factors, and outcomes of AKI in patients hospitalized with COVID-19 in Kenya. Methods This retrospective cohort study included 1366 patients with confirmed COVID-19 illness hospitalized at the Aga Khan University Hospital in Nairobi, Kenya, between April 1, 2020 and October 31, 2021. Data were collected on age, sex, the severity of COVID-19 illness, existing pregnancy and comorbid conditions including human immunodeficiency virus (HIV), diabetes mellitus, hypertension, and functioning kidney transplant patients. Univariate analysis was carried out to determine the association of clinical and demographic factors with AKI. To determine independent associations with AKI incidence, a logistic regression model was used and the relationship was reported as odds ratios (ORs) with a 95% confidence interval (CI). The outcomes of AKI including the in-hospital mortality rate, renal recovery rate at hospital discharge, and the duration of hospital stay were reported and stratified based on the stage of AKI. Results The median age of study patients was 56 years (interquartile range [IQR] = 45-68 years), with 67% of them being male (914 of 1366). The AKI incidence rate was 21.6% (n = 295). Patients with AKI were older (median age = 64 years vs 54 years; P < .001), majority male (79% of men with AKI vs 63.6% without AKI; P < .001), and likely to have a critical COVID-19 (OR = 8.03, 95% CI = 5.56-11.60; P < .001). Diabetes and hypertension, with an adjusted OR of 1.75 (95% CI = 1.34-2.30; P < .001) and 1.68 (95% CI = 1.27-2.23; P < .001), respectively, were associated with AKI occurrence in COVID-19. Human immunodeficiency virus, pregnancy, and a history of renal transplant were not significantly associated with increased AKI risk in this study. Patients with AKI had significantly higher odds of mortality, and this effect was proportional to the stage of AKI (OR = 11.35, 95% CI = 7.56-17.03; P < .001). 95% of patients with stage 1 AKI had complete renal recovery vs 33% of patients with stage 3 AKI. Of the patients with stage 3 AKI (n = 64), 10 underwent hemodialysis, with 1 recovery in renal function and 3 patients requiring ongoing dialysis after discharge. Conclusions This study was conducted at a single private tertiary-level health care facility in Kenya and only up to the time of hospital discharge. It is one of the first large studies from sub-Saharan Africa looking at the associated factors and outcomes of AKI in COVID-19 and forms a foundation for further analysis on the long-term consequences of COVID-19 on the kidneys. A major limitation of the study is the lack of baseline pre-admission creatinine values for most patients; thus, the impact of chronic kidney disease/baseline creatinine values on the incidence of AKI could not be established.
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Xu Q, Li F, Chen X. Factors Affecting Mortality in Elderly Hypertensive Hospitalized Patients with COVID-19: A Retrospective Study. Clin Interv Aging 2023; 18:1905-1921. [PMID: 38020447 PMCID: PMC10674107 DOI: 10.2147/cia.s431271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Corona Virus Disease 2019 (COVID-19) endangers the health and survival of the elderly. We tried to explore factors especially kidney function which affected mortality in elderly hypertensive patients with COVID-19. Methods We conducted a retrospective research of 748 COVID-19 elderly patients (≥65 years old) at Zhejiang Hospital. This study compared demographic data, laboratory values, comorbidities, treatments, and clinical outcomes of hypertension and non-hypertension participants, and subgroup analysis of age and frailty was conducted in the hypertension population. Survival analysis was used to determine risk factors for death in elderly patients with COVID-19. Results Our study revealed that the elderly hypertensive patients with COVID-19 had higher blood urea nitrogen (BUN), serum uric acid (UA), serum creatinine (Scr), lower estimated glomerular filtration rate (eGFR), higher incidence of severity, admission to intensive care unit (ICU) and death, and longer in-hospital stay than non-hypertensive patients, which also occurred in the very elderly hypertensive patients compared with younger hypertensive patients and frail hypertensive patients compared with no-frail hypertensive patients. In addition, the prevalence of acute kidney injury (AKI) was higher in the oldest old hypertensive patients and frail hypertensive patients. Multivariate survival analysis indicated that the independent risk factors for death from COVID-19 were age ≥80 years, heart failure, antiviral therapy, calcium channel blocker (CCB) therapy, mechanical ventilation, AKI, and eGFR<60 mL/min per 1.73 m2. Conclusion The results of the present study suggested that the elderly hypertensive patients with COVID-19 would have more serious kidney injury, more serious disease progression and higher mortality, which also occurred in very elderly and frailty subgroup. Kidney dysfunction was closely related to mortality in elderly patients with COVID-19.
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Affiliation(s)
- Qun Xu
- School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Fangzhou Li
- Department of Geriatrics, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Xujiao Chen
- Department of Geriatrics, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, Zhejiang Province, People’s Republic of China
- Zhejiang Hospital, Hangzhou, Zhejiang Province, People's Republic of China
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He M, Wang Y, Li S, Gillespie A. Nationwide in-hospital mortality and morbidity analysis of COVID-19 in advanced chronic kidney disease, dialysis and kidney transplant recipients. Front Med (Lausanne) 2023; 10:1250631. [PMID: 38020145 PMCID: PMC10652751 DOI: 10.3389/fmed.2023.1250631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/02/2023] [Indexed: 12/01/2023] Open
Abstract
Background Patients with advanced chronic kidney disease (CKD), end-stage kidney disease (ESKD), and kidney transplants (KT) are at an elevated risk for COVID-19 infection, hospitalization, and mortality. A comprehensive comparison of morbidity and mortality between these populations with kidney disease and individuals without any kidney disease is lacking. Methods We analysed the 2020 Nationwide Inpatient Sample (NIS) database for non-elective adult COVID-19 hospitalizations, categorizing patients into advanced CKD, ESKD, KT, and kidney disease-free cohorts. Our analysis included a description of the distribution of comorbidities across the entire spectrum of CKD, ESKD, and KT. Additionally, we investigated in-hospital mortality, morbidity, and resource utilization, adjusting for potential confounders through multivariable regression models. Results The study included 1,018,915 adults hospitalized for COVID-19 in 2020. The incidence of advanced CKD, ESKD, and KT in this cohort was 5.8%, 3.8%, and 0.4%, respectively. Patients with advanced CKD, ESKD, and KT exhibited higher multimorbidity burdens, with 90.3%, 91.0%, and 75.2% of patients in each group having a Charlson comorbidity index (CCI) equal to or greater than 3. The all-cause in-hospital mortality ranged from 9.3% in kidney disease-free patients to 20.6% in advanced CKD, 19.4% in ESKD, and 12.4% in KT patients. After adjusting for potential confounders at both the patient and hospital levels, CKD stages 3-5; ESKD; and KT were found to be associated with increased odds of mortality, with adjusted odds ratios (aOR) of 1.34, 1.80, 2.66, 1.97, and 1.69, respectively. Conclusion Patients hospitalized for COVID-19 with advanced CKD, ESKD, or KT demonstrated a higher burden of comorbidities and increased mortality rates compared to those without kidney disease. After adjusting for confounders, CKD stages 3-5; ESKD; and KT were identified as independent risk factors for in-hospital mortality, illustrating a dose-response relationship between the odds of mortality and adverse outcomes as CKD progressed from stages 3 to 5. Our study highlights the necessity for enhanced management of comorbidities, targeted interventions, and vigorous vaccination efforts to mitigate the risk of adverse outcomes in the vulnerable populations of patients with CKD, ESKD, and KT.
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Affiliation(s)
- Mingyue He
- Department of Internal Medicine, Temple University Hospital, Philadelphia, PA, United States
| | - Yichen Wang
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Si Li
- Department of Internal Medicine, Temple University Hospital, Philadelphia, PA, United States
| | - Avrum Gillespie
- Section of Nephrology, Hypertension and Kidney Transplantation, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States
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10
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Jafarian_amiri SR, Qanbari Qalehsari M, Zabihi A, Babanataj R, Chehrazi M. The relationship between empowerment and compassion satisfaction, compassion fatigue, and burnout in nurses during COVID-19 outbreak. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:379. [PMID: 38144007 PMCID: PMC10743936 DOI: 10.4103/jehp.jehp_504_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/07/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND The quality of nurses' professional life is at stake in crises such as COVID-19. Empowerment helps employees perform better and advance the goals of the organization. This study aimed to investigate the relationship between empowerment and the quality of nurses' professional life during the outbreak of COVID-19. MATERIALS AND METHODS The current cross-sectional study was conducted in 2021 in the hospitals of Babol University of Medical Sciences with the participation of 200 nurses providing care for COVID-19 patients who were included in the study by convenience sampling method. Data collection tools included the Empowerment Questionnaire (Leader Empowerment Behaviors Scale, Structural Empowerment, and Psychological Empowerment) and the Professional Quality of Life Questionnaire. SPSS software version 23 was used to analyze the data. Multiple linear regressions were used to investigate the relationship between empowerment and quality of professional life. RESULTS In the majority of nurses, compassion satisfaction 140 (70%), burnout 172 (86%), and compassion fatigue 126 (63%) were at moderate level. A significant relationship was found between compassion satisfaction and Leader Empowerment (R = 0.54, P =. 001), Psychological Empowerment (R = 0.55, P =. 001), and Structural Empowerment (R = 0.42, P =. 001) and Compassion Fatigue and Leader Empowerment (R = 0.35, P =. 001), psychological empowerment (R = 0.42, P =. 001), and structural empowerment (R = 0.49, P =. 001). CONCLUSION Nursing managers' attention to empowerment strategies in crises such as COVID-19 can improve compassion satisfaction and reduce compassion fatigue in nurses. It is also necessary to implement policies and guidelines for the development of psychosocial support to health promotion of the workplace, education, informing, and empowering nurses.
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Affiliation(s)
- Seyedeh Roghayeh Jafarian_amiri
- Department of Medical and Surgical Nursing, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Mojtaba Qanbari Qalehsari
- Nursing Care Research Center, Health Research Institute, Nursing and Midwifery School, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Ali Zabihi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Reyhaneh Babanataj
- Trauma Nursing Research Center, Medical Surgical of Science Department, Faculty of Nursing, Kashan University of Medical Science, Kashan, Islamic Republic of Iran
| | - Mohammad Chehrazi
- Department of Epidemiology and Biostatistics, School of Health, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
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11
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Bento GAO, Leite VLT, Campos RP, Vaz FB, Daher EDF, Duarte DB. Reduction of estimated glomerular filtration rate after COVID-19-associated acute kidney injury. J Bras Nefrol 2023; 45:488-494. [PMID: 37311051 PMCID: PMC10726661 DOI: 10.1590/2175-8239-jbn-2022-0179en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/10/2023] [Indexed: 06/15/2023] Open
Abstract
INTRODUCTION Acute Kidney Injury (AKI), a frequent manifestation in COVID-19, can compromise kidney function in the long term. We evaluated renal function after hospital discharge of patients who developed AKI associated with COVID-19. METHODS This is an ambidirectional cohort. eGFR and microalbuminuria were reassessed after hospital discharge (T1) in patients who developed AKI due to COVID-19, comparing the values with hospitalization data (T0). P < 0.05 was considered statistically significant. RESULTS After an average of 16.3 ± 3.5 months, 20 patients were reassessed. There was a median reduction of 11.5 (IQR: -21; -2.1) mL/min/1.73m2 per year in eGFR. Forty-five percent of patients had CKD at T1, were older, and had been hospitalized longer; this correlated negatively with eGFR at T1. Microalbuminuria was positively correlated with CRP at T0 and with a drop in eGFR, as well as eGFR at admission with eGFR at T1. CONCLUSION There was a significant reduction in eGFR after AKI due to COVID-19, being associated with age, length of hospital stay, CRP, and need for hemodialysis.
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Affiliation(s)
| | | | - Rodrigo Peixoto Campos
- Universidade Federal de Alagoas, Faculdade de Medicina, Maceió, AL, Brazil
- Centro Universitário CESMAC, Faculdade de Medicina, Maceió, AL, Brazil
| | - Flora Braga Vaz
- Centro Universitário CESMAC, Faculdade de Medicina, Maceió, AL, Brazil
| | | | - Daniella Bezerra Duarte
- Centro Universitário Tiradentes, Faculdade de Medicina, Maceió, AL, Brazil
- Universidade Federal de Alagoas, Faculdade de Medicina, Maceió, AL, Brazil
- Centro Universitário CESMAC, Faculdade de Medicina, Maceió, AL, Brazil
- Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza, CE, Brazil
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12
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Hamad A, Elgaali M, Ghonimi T, Elshirbeny M, Ali M, Ibrahim R, Othman M, Abuhelaiqa E, Ezzat H, Boubaker K, Alkadi M, Al-Malki H. From past to present: Exploring COVID-19 in Qatar's hemodialysis population across Omicron dominant and pre-Omicron periods. PLoS One 2023; 18:e0291266. [PMID: 37708230 PMCID: PMC10501587 DOI: 10.1371/journal.pone.0291266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/24/2023] [Indexed: 09/16/2023] Open
Abstract
COVID-19 carries a high risk of morbidity and mortality in dialysis patients. Multiple SARS-CoV-2 variants have been identified since the start of the COVID-19 pandemic. The current study aimed to compare the incidence and outcomes of the COVID-19 Omicron dominant period versus other pre-Omicron period in hemodialysis patients. In this observational, analytical, retrospective, nationwide study, we reviewed adult chronic hemodialysis patients between March 1, 2020, and January 31, 2022. Four hundred twenty-one patients had COVID-19 during the study period. The incidence of COVID-19 due to the Omicron dominant period was significantly higher than other pre-Omicron period (30.3% vs. 18.7%, P<0.001). In contrast, the admission rate to ICU was significantly lower in the Omicron dominant period than in the pre-Omicron period (2.8% vs. 25%, P<0001) but with no significant difference in ICU length of stay. The mortality rate was lower in the Omicron dominant period compared to the pre-Omicron period (2.4% vs. 15.5%, P<0.001). Using multivariate analysis, older age [OR 1.093 (95% CI 1.044-1.145); P<0.0001] and need for mechanical ventilation [OR 70.4 (95% CI 20.39-243.1); P<0.0001] were identified as two independent risk factors for death in hemodialysis patients with COVID-19. In Conclusion, the COVID-19 Omicron variant had a higher incidence and lower morbidity and mortality than pre-Omicron period in our hemodialysis population.
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Affiliation(s)
- Abdullah Hamad
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Musab Elgaali
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Tarek Ghonimi
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mostafa Elshirbeny
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Ali
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Rania Ibrahim
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Muftah Othman
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Essa Abuhelaiqa
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Hany Ezzat
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Karima Boubaker
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamad Alkadi
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Hassan Al-Malki
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
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13
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Mondal M, Islam MN, Ullah A, Haque MR, Rahman M, Bosak L, Rahman MF, Zaman SR, Rahman MM. Clinical manifestations and outcomes of COVID-19 in maintenance hemodialysis patients of a high infectious epidemic country: a prospective cross-sectional study. Ann Med Surg (Lond) 2023; 85:4293-4299. [PMID: 37663710 PMCID: PMC10473334 DOI: 10.1097/ms9.0000000000001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/01/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction The outbreak of COVID-19 poses great challenges for patients on maintenance haemodialysis. Here, we reported the clinical characteristics and laboratory features of maintenance haemodialysis (MHD) patients with COVID-19 in Bangladesh. Methods Altogether, 67 MHD patients were enroled in the study from two dedicated tertiary-level hospitals for COVID-19 after the prospective cross-sectional execution of selection criteria. Data were collected from medical records and interviews. Different statistical analysis was carried out in the data analysis. Results The mean age was 55.0±9.9 years, with 40 males (59.7%). The mean dialysis duration was 23.4±11.5 months. The most common symptoms were fever (82.1%), cough (53.7%), and shortness of breath (55.2%), while the common comorbid condition was hypertension (98.5%), followed by diabetes (56.7%). Among MHD patients, 52.2% to 79.1% suffered from severe to critical COVID-19, 48 patients (71.6%) had 26-75% lung involvement on high resolution computed tomography of the chest, 23 patients (34.3%) did not survive, 20 patients (29.9%) were admitted to ICU, and nine patients (13.4%) needed mechanical ventilation. Patients who did not survive were significantly older (mean age: 63.0 vs. 50.86 years, P=0.0001), had significantly higher cardiovascular risk factors (69.6% vs. 43.2%, P=0.04), severe shortness of breath (82.6% vs. 40.9%, P=0.0001), and longer hospital stays (mean days: 17.9 vs. 13.0, P=0,0001) compared to the survivor group. The white blood cell count, C-reactive protein, lactate dehydrogenase, pro-calcitonin, and thrombocytopenia were significantly (P<0.0001) higher, while the albumin level was significantly lower (P=0.0001) in non-survivor compared to patients who survived. Conclusion Maintenance haemodialysis patients had severe to critical COVID-19 and had a higher risk of non-survival if they were older and had comorbidities such as hypertension and diabetes. Therefore, MHD patients with COVID-19 need close monitoring to improve their outcomes.
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Affiliation(s)
- Mina Mondal
- Department of Nephrology, Khulna Medical College, Khulna
| | | | | | | | - Motiur Rahman
- Kalkini Upzilla Health Complex, Kalkini, Madaripur, Bangladesh
| | - Liza Bosak
- Basic Science Division, World University of Bangladesh
| | - Md. Foyzur Rahman
- Department of Community Medicine, National Institute of Preventive and Social Medicine (NIPSOM)
| | | | - Mohammad Meshbahur Rahman
- Department of Biostatistics, National Institute of Preventive and Social Medicine (NIPSOM), Mohakhali, Dhaka
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14
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Ibrahim M, Saeed E, Hamarsheh I, Al Zabadi H, Ahmead M. Depression and death anxiety among patients undergoing hemodialysis during the COVID-19 pandemic in Palestine: a cross sectional study. Front Psychiatry 2023; 14:1247801. [PMID: 37720896 PMCID: PMC10501786 DOI: 10.3389/fpsyt.2023.1247801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/01/2023] [Indexed: 09/19/2023] Open
Abstract
Background Hemodialysis patients are vulnerable to serious complications such as prolonged hospital stay and psychosocial issues like depression and death anxiety. Studies on psychosocial factors on end-stage renal disease patients' outcomes during COVID-19 pandemic are limited. We aimed to determine the prevalence of depression and death anxiety among Palestinian hemodialysis patients and the evaluate the relationship between their sociodemographic and clinical characteristics during COVID-19 Pandemic. Methods A cross-sectional study was conducted using a convenience sampling technique. We recruited 308 hemodialysis patients from five hemodialysis units located in government hospitals in Palestine. Beck Depression Inventory and the Templers Death Anxiety Scale were used to collect data, which were then analyzed using SPSS version 20. Descriptive statistics (frequencies and means), t-test, ANOVA and multiple linear regression models were used for data analysis. Results Nearly 66.2% of the sample had depression symptoms, 61.4% met the diagnostic threshold for depression, and 69.8% had death anxiety. Furthermore, the multivariate analysis revealed that having a female identity, residing in a city or refugee camp, and patients who reported not experiencing depression had a significant relationship with death anxiety, while having a higher educational level than 12 years, having one or more chronic co-morbidities, and patients who reported experiencing death anxiety had a significant correlation with depression. Conclusion Patients receiving hemodialysis frequently experience depression and death anxiety. These patients should receive a psychiatric evaluation in the early stages of their illness so that timely and appropriate psychological interventions can be given in hemodialysis facilities in Palestine during and after future pandemics.
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Affiliation(s)
| | - Elias Saeed
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Islam Hamarsheh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Hamzeh Al Zabadi
- Department of Public Health, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Muna Ahmead
- Faculty of Public Health, Al-Quds University, Jerusalem, Palestine
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15
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Palacios CRF, Hoxhaj R, Thigpen C, Jacob J, Bhatnagar A, Saberi A. Outcomes of patients with COVID-19 requiring extracorporeal membrane oxygenation and continuous renal replacement therapy in the United States. Acute Crit Care 2023; 38:308-314. [PMID: 37652860 PMCID: PMC10497892 DOI: 10.4266/acc.2023.00115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/25/2023] [Accepted: 06/22/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) infection is associated with significant morbidity and mortality. Some patients develop severe acute respiratory distress syndrome and kidney failure requiring the combination of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). METHODS Retrospective cohort study of 127 consecutive patients requiring combined ECMO and CRRT support in intensive care units at an ECMO center in Marietta, GA, United States. RESULTS Sixty and 67 patients with and without COVID-19, respectively, required ECMO-CRRT support. After adjusting for confounding variables, patients with COVID-19 had increased mortality at 30 days (hazard ratio [HR], 5.19; 95% confidence interval [CI], 2.51-10.7; P<0.001) and 90 days (HR, 6.23; 95% CI, 2.60-14.9; P<0.001). CONCLUSIONS In this retrospective study, patients with COVID-19 who required ECMO-CRRT had increased mortality when compared to patients without COVID-19.
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Affiliation(s)
| | - Rudiona Hoxhaj
- Internal Medicine, WellStar Health System, Marietta, GA, USA
| | - Catlyn Thigpen
- Internal Medicine, WellStar Health System, Marietta, GA, USA
| | - Jeffrey Jacob
- Internal Medicine, WellStar Health System, Marietta, GA, USA
| | - Atul Bhatnagar
- Critical Care Medicine, WellStar Health System, Marietta, GA, USA
| | - Asif Saberi
- Critical Care Medicine, WellStar Health System, Marietta, GA, USA
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16
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Puspitasari M, Sattwika PD, Rahari DS, Wijaya W, Hidayat ARP, Kertia N, Purwanto B, Thobari JA. Immunogenicity and safety of inactivated SARS-CoV-2 vaccine in haemodialysis patients: a prospective cohort study. Sci Rep 2023; 13:11557. [PMID: 37463975 PMCID: PMC10354113 DOI: 10.1038/s41598-023-38628-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/12/2023] [Indexed: 07/20/2023] Open
Abstract
End-stage renal disease patients on haemodialysis (HD) have been largely excluded from SARS-CoV-2 vaccine trials due to safety reasons and shown to mount lower responses to vaccination. This study aims to evaluate the immunogenicity and safety of inactivated COVID-19 vaccine among HD patients compared to healthy controls. All subjects who received the primary inactivated COVID-19 vaccination had their blood samples tested 21 days after the second dose. We report the immunogenicity based on anti-RBD IgG titre (IU/mL), the inhibition rate of neutralizing antibodies (NAbs) (%) to RBD, and seroconversion rates. Adverse events were assessed within 30 min and on the 7th day after each dose. Among 75 HD patients and 71 healthy controls, we observed no significant difference in all immunogenicity measures: anti-RBD IgG GMT (277.91 ± 7.13 IU/mL vs. 315.50 ± 3.50 IU/mL, p = 0.645), NAbs inhibition rate (82% [53-96] vs. 84% [39-98], p = 0.654), and seroconversion rates (anti-RBD IgG: 86.7% vs. 85.9%, p = 0.895; NAbs: 45.3% vs. 60.6%, p = 0.065). The number of adverse events is not significantly different between the two groups. The primary inactivated SARS-CoV-2 vaccination elicits an adequate antibody response and can be safely administered in haemodialysis patients.
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Affiliation(s)
- Metalia Puspitasari
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia.
| | - Prenali D Sattwika
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
- Clinical Epidemiology and Biostatistics Unit, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
- Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Dzerlina S Rahari
- Clinical Epidemiology and Biostatistics Unit, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Wynne Wijaya
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Auliana R P Hidayat
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Nyoman Kertia
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Bambang Purwanto
- Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Jarir At Thobari
- Clinical Epidemiology and Biostatistics Unit, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
- Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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17
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Wei H, Li X, Li C, Wang K, Liu Z, Lu J, Liu B, He X. Improving the adsorption performance of urea by using polyhydroxy groups to modify two-dimensional Ti3C2Tx. CHEMOSPHERE 2023:139303. [PMID: 37369284 DOI: 10.1016/j.chemosphere.2023.139303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/06/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023]
Abstract
Wearable artificial kidney can provide continuous dynamic dialysis for uremia patients. For the sake of practical application, the critical step is to find an adsorbent that can effectively remove urea and have excellent biological compatibility. The layered Ti3C2Tx (DL-Ti3C2Tx) with high specific surface area and good dispersion was prepared by a two-step etching method. From the first principles calculation, urea can be adsorbed by different groups (-F, -O, -OH) on the surface of Ti3C2Tx, among which -OH has the greatest binding energy to urea. Therefore, DL-Ti3C2Tx was modified with different alkali solutions (KOH, NaOH, LiOH) to introduce -OH on the surface, which can increase the adsorption capacity of urea. The experimental results showed that DL-Ti3C2Tx (LiOH-Ti3C2Tx) after treated by LiOH had the highest urea adsorption efficiency, and the urea removal rate of LiOH-Ti3C2Tx was still higher than 92% when the urea concentration was 500 mg/L. In the Simulated dialysate, Ti3C2Tx treated with three kinds of alkali solutions still maintained a good adsorption efficiency for urea, and still had a certain adsorption capacity after recycling for four times. Biocompatibility experiments showed that Ti3C2Tx in different concentrations did not cause hemolysis of erythrocyte, and had no obvious damage to vascular endothelial cells. This study greatly improves the urea adsorption efficiency of MXene, which has a broad application prospect in the selection of adsorbent for wearable artificial kidney.
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Affiliation(s)
- Hong Wei
- Faculy of Materials Metallurgy and Chemistry, Jiangxi University of Science and Technology, Ganzhou, Jiangxi, China
| | - Xiao Li
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China; Institute for Department of Physiology, School of Basic Medical Sciences, Gannan Medical University, Ganzhou, China
| | - Cong Li
- Faculy of Materials Metallurgy and Chemistry, Jiangxi University of Science and Technology, Ganzhou, Jiangxi, China
| | - Kaidi Wang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China
| | - Zhiping Liu
- Faculy of Materials Metallurgy and Chemistry, Jiangxi University of Science and Technology, Ganzhou, Jiangxi, China
| | - Jiarui Lu
- Faculy of Materials Metallurgy and Chemistry, Jiangxi University of Science and Technology, Ganzhou, Jiangxi, China
| | - Baixiong Liu
- Faculy of Materials Metallurgy and Chemistry, Jiangxi University of Science and Technology, Ganzhou, Jiangxi, China.
| | - Xingyu He
- Faculy of Materials Metallurgy and Chemistry, Jiangxi University of Science and Technology, Ganzhou, Jiangxi, China.
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Orsi SM, Pepino C, Rossoni L, Serafino M, Caorsi R, Volpi S, Palmeri S, Faragli A, Lugani F, Bigatti C, Ghiggeri GM, Verrina EE, La Porta E, Angeletti A. Case Report: Multisystem inflammatory syndrome in children with associated proximal tubular injury. FRONTIERS IN NEPHROLOGY 2023; 3:1194989. [PMID: 37675350 PMCID: PMC10479668 DOI: 10.3389/fneph.2023.1194989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/30/2023] [Indexed: 09/08/2023]
Abstract
Introduction SARS-CoV-2 infection in the pediatric population can be associated with a multiorgan inflammatory syndrome called children's multisystem inflammatory syndrome (MIS-C). The kidneys can be affected by a broad spectrum of possible injuries, whose pathogenetic mechanisms are still unclear.Case report: We report the case of a 5-year-old boy with severe cardiac involvement in the context of MIS-C. After two weeks of hospitalization, an abdominal ultrasound showed massive bladder "debris", followed by the onset of normoglycemic glycosuria. Over time, there was a progressive increase in glycosuria, and the presence of a mat of amorphous phosphate crystals was evidenced on urinary sediment. Together with the findings of hypo-uricemia, increased urinary uric acid, and globally increased urinary amino acids, a clinical picture of kidney proximal tubular damage with secondary Fanconi-like syndrome took shape. Discussion This case report describes the case of a patient with MIS-C with cardiac and kidney involvement characterized by proximal tubular damage, which slowly improved but still persisted at the 8-month follow-up. The pathogenesis of the damage is unclear and probably multifactorial.
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Affiliation(s)
- Silvia Maria Orsi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Carlotta Pepino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Lisa Rossoni
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Margherita Serafino
- Department of Pediatric Cardiology and Cardiac Surgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Roberta Caorsi
- Center for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Stefano Volpi
- Center for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Serena Palmeri
- Center for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Alessandro Faragli
- Department of Internal Medicine and Cardiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Francesca Lugani
- Division of Nephrology, Dialysis and Transplantation, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Laboratory of Molecular Nephrology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Carolina Bigatti
- Division of Nephrology, Dialysis and Transplantation, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Laboratory of Molecular Nephrology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Gian Marco Ghiggeri
- Division of Nephrology, Dialysis and Transplantation, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Laboratory of Molecular Nephrology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Enrico Eugenio Verrina
- Division of Nephrology, Dialysis and Transplantation, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Dialysis Unit, Department of Pediatric, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Edoardo La Porta
- Division of Nephrology, Dialysis and Transplantation, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Dialysis Unit, Department of Pediatric, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Andrea Angeletti
- Division of Nephrology, Dialysis and Transplantation, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Laboratory of Molecular Nephrology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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19
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Shoueir K, Wahba AM, El Marouazi H, Janowska I. Performant removal of creatinine using few-layer-graphene/alginate beads as a kidney filter. Int J Biol Macromol 2023:124936. [PMID: 37236566 DOI: 10.1016/j.ijbiomac.2023.124936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/05/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
Reduction of renal function, such as creatinine adsorption is one of the most common and dangerous diseases. Dedicated to this issue, developing high-performance, sustainable, and bio-compatible adsorbing materials is still challenging. Herein, barium alginate (BA) and BA containing few-layer graphene (FLG/BA) beads were synthesized in water from sodium alginate, also acting as bio-surfactant in in-situ exfoliation of graphite to FLG. The physicochemical characteristics of the beads demonstrated an excess of barium chloride used as a cross-linker. The efficiency and sorption capacity (Qe) of creatinine removal increase with processing duration reaching 82.1, 99.5 %, and 68.4, 82.9 mg·g-1 for BA and FLG/BA, respectively. The thermodynamic parameters detect the enthalpy change (ΔH°) of about -24.29 and -36.11 kJ·mol-1 and the entropy change (ΔS°) of around -69.24 and -79.46 kJ·mol-1 for BA and FLG/BA, respectively. During the reusability test, the removal efficiency decreases from the optimal first cycle to 69.1 and to 88.3 % in the sixth cycle for BA and FLG/BA, revealing superior stability of FLG/BA. The MD calculations confirm a higher adsorption capacity of FLG/BA composite compared to BA alone, clearly confirming a strong structure-property relation.
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Affiliation(s)
- Kamel Shoueir
- Institute of Nanoscience & Nanotechnology, Kafrelsheikh University, 33516 Kafrelsheikh, Egypt; Institut de Chimie et Procédés pour l'Énergie, l'Environnement et la Santé (ICPEES), CNRS UMR 7515-Université de Strasbourg, 25 rue Becquerel, 67087 Strasbourg, France.
| | - Ahmed M Wahba
- Department of Basic Science, Higher Institute of Engineering and Technology (HIET), El-Mahalla, Egypt
| | - Hamza El Marouazi
- Institut de Chimie et Procédés pour l'Énergie, l'Environnement et la Santé (ICPEES), CNRS UMR 7515-Université de Strasbourg, 25 rue Becquerel, 67087 Strasbourg, France
| | - Izabela Janowska
- Institut de Chimie et Procédés pour l'Énergie, l'Environnement et la Santé (ICPEES), CNRS UMR 7515-Université de Strasbourg, 25 rue Becquerel, 67087 Strasbourg, France.
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20
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Shoushtari MHZ, Safapour N, Savaie M, Raji H, Cheraghian B. Demographic features, laboratory findings and outcomes of ICU patients with COVID-19 in Ahvaz, Iran: A single-centered prospective study. J Family Med Prim Care 2023; 12:881-887. [PMID: 37448932 PMCID: PMC10336945 DOI: 10.4103/jfmpc.jfmpc_1061_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/19/2022] [Accepted: 08/27/2022] [Indexed: 07/18/2023] Open
Abstract
Background COVID-19 can lead to severe acute respiratory syndrome so that some patients need to be admitted to the Intensive Care Unit (ICU). The aim of the current study is to investigate the frequency of demographic, laboratory and imaging findings and type of treatment and their relationship with disease outcomes in patients with COVID-19. Material and Methods This prospective cross-sectional study was conducted on all patients with COVID-19 who were admitted in the ICU of Razi Hospital in Ahvaz, Iran from January 20 to February 20, 2021. Patient information including demographic features, laboratory and imaging findings and clinical outcomes was recorded. Results One hundred and thirty-three patients were recruited in the present study, out of which 74 patients (55.6%) were males and 59 patients (44.4%) were females. The overall mortality rate of patients was 35.3% (47 patients) and was higher in patients over 65 years of age. There was a significant difference in terms of thrombocytopenia (P value: 0.001), lymphopenia (P value: 0.004), progression of lung involvement in imaging, shock, disseminated intravascular coagulation (DIC), sepsis and receiving invasive respiratory support in living and deceased patients (P value < 0.001). Furthermore, the difference in life status and the length of in-ICU stay in patients with hyperkalemia and renal failure was statistically significant (P value = 0.033, P value < 0.001 respectively). Conclusion Mortality rate of patients with COVID- 19 admitted to ICU is generally high. According to the findings of this study, thrombocytopenia, lymphopenia, hyperkalemia and AKI are laboratory disorders associated with increased mortality. Moreover, the progression of pulmonary involvement in imaging, shock, DIC, sepsis, and need to invasive respiratory support is associated with low survival of patients.
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Affiliation(s)
| | - Neda Safapour
- Dapartment of Internal Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohsen Savaie
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hanieh Raji
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Biostatistic, School of Public Health, Ahvaz Jundishpur University of Medical Sciences, Ahvaz, Iran
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21
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Sánchez ADLV, Pérez AN, Pérez-Carrasco M, Sonet MT, Buendia YD, Ballujera PO, López MR, Riera JS, Olmo-Isasmendi A, Torra EV, García-Pumarino MÁ, Villamayor MI, Catalán Ibars RM, Zelaya IO, Chica JP, Anglès CR, Tomasa-Irriguible TM, Serra AB, Casanova EJ, De Molina FJG. "Acute kidney injury in critically ill patients with COVID-19: The AKICOV multicenter study in Catalonia". PLoS One 2023; 18:e0284248. [PMID: 37058544 PMCID: PMC10104297 DOI: 10.1371/journal.pone.0284248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/27/2023] [Indexed: 04/15/2023] Open
Abstract
This study describes the incidence, evolution and prognosis of acute kidney injury (AKI) in critical COVID-19 during the first pandemic wave. We performed a prospective, observational, multicenter study of confirmed COVID-19 patients admitted to 19 intensive care units (ICUs) in Catalonia (Spain). Data regarding demographics, comorbidities, drug and medical treatment, physiological and laboratory results, AKI development, need for renal replacement therapy (RRT) and clinical outcomes were collected. Descriptive statistics and logistic regression analysis for AKI development and mortality were used. A total of 1,642 patients were enrolled (mean age 63 (15.95) years, 67.5% male). Mechanical ventilation (MV) was required for 80.8% and 64.4% of these patients, who were in prone position, while 67.7% received vasopressors. AKI at ICU admission was 28.4% and increased to 40.1% during ICU stay. A total of 172 (10.9%) patients required RRT, which represents 27.8% of the patients who developed AKI. AKI was more frequent in severe acute respiratory distress syndrome (ARDS) ARDS patients (68% vs 53.6%, p<0.001) and in MV patients (91.9% vs 77.7%, p<0.001), who required the prone position more frequently (74.8 vs 61%, p<0.001) and developed more infections. ICU and hospital mortality were increased in AKI patients (48.2% vs 17.7% and 51.1% vs 19%, p <0.001) respectively). AKI was an independent factor associated with mortality (IC 1.587-3.190). Mortality was higher in AKI patients who required RRT (55.8% vs 48.2%, p <0.04). Conclusions There is a high incidence of AKI in critically ill patients with COVID-19 disease and it is associated with higher mortality, increased organ failure, nosocomial infections and prolonged ICU stay.
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Affiliation(s)
- Arsenio De La Vega Sánchez
- Intensive Care Department, Vall d’Hebron Hospital Universitari, Barcelona, Spain
- Shock, Organ Dysfunction and Resuscitation Research Group, Universitat Autònoma de Barcelona, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
| | - Ana Navas Pérez
- Critical Care Center, Parc Tauli Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Marcos Pérez-Carrasco
- Intensive Care Department, Vall d’Hebron Hospital Universitari, Barcelona, Spain
- Shock, Organ Dysfunction and Resuscitation Research Group, Universitat Autònoma de Barcelona, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
| | - María Torrens Sonet
- Intensive Care Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Miguel Rodríguez López
- Critical Care Department, Hospital del Baix Llobregat Moises Broggi Sant Joan Despí, Barcelona, Spain
| | - Joan Sabater Riera
- Intensive Care Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Aitor Olmo-Isasmendi
- Critical Care Department Hospital Universitari General de Catalunya Sant Cugat del Vallès, Sant Cugat del Vallès, Barcelona, Spain
| | - Ester Vendrell Torra
- Intensive Care Department, Hospital General de Granollers, Granollers, Barcelona, Spain
| | | | | | | | | | - Javier Pardos Chica
- Servicio Medicina Intensiva, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | | | | | - Anna Baró Serra
- Critical Care Department Hospital Santa Caterina de Salt, Girona, Spain
| | - Edward J. Casanova
- Critical Care Department Hospital Asepeyo Sant Cugat del Vallès, Sant Cugat del Vallès, Barcelona, Spain
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22
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Jin X, Wang Y, Xu J, Li Y, Cheng F, Luo Y, Zhou H, Lin S, Xiao F, Zhang L, Lin Y, Zhang Z, Jin Y, Zheng F, Chen W, Zhu A, Tao Y, Zhao J, Kuo T, Li Y, Li L, Wen L, Ou R, Li F, Lin L, Zhang Y, Sun J, Yuan H, Zhuang Z, Sun H, Chen Z, Li J, Zhuo J, Chen D, Zhang S, Sun Y, Wei P, Yuan J, Xu T, Yang H, Wang J, Xu X, Zhong N, Xu Y, Sun K, Zhao J. Plasma cell-free DNA promise monitoring and tissue injury assessment of COVID-19. Mol Genet Genomics 2023; 298:823-836. [PMID: 37059908 PMCID: PMC10104435 DOI: 10.1007/s00438-023-02014-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/25/2023] [Indexed: 04/16/2023]
Abstract
Coronavirus 2019 (COVID-19) is a complex disease that affects billions of people worldwide. Currently, effective etiological treatment of COVID-19 is still lacking; COVID-19 also causes damages to various organs that affects therapeutics and mortality of the patients. Surveillance of the treatment responses and organ injury assessment of COVID-19 patients are of high clinical value. In this study, we investigated the characteristic fragmentation patterns and explored the potential in tissue injury assessment of plasma cell-free DNA in COVID-19 patients. Through recruitment of 37 COVID-19 patients, 32 controls and analysis of 208 blood samples upon diagnosis and during treatment, we report gross abnormalities in cfDNA of COVID-19 patients, including elevated GC content, altered molecule size and end motif patterns. More importantly, such cfDNA fragmentation characteristics reflect patient-specific physiological changes during treatment. Further analysis on cfDNA tissue-of-origin tracing reveals frequent tissue injuries in COVID-19 patients, which is supported by clinical diagnoses. Hence, our work demonstrates and extends the translational merit of cfDNA fragmentation pattern as valuable analyte for effective treatment monitoring, as well as tissue injury assessment in COVID-19.
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Affiliation(s)
- Xin Jin
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China.
- School of Medicine, South China University of Technology, Guangzhou, 510006, Guangdong, China.
| | - Yanqun Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Jinjin Xu
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
| | - Yimin Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Fanjun Cheng
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Yuxue Luo
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
- School of Medicine, South China University of Technology, Guangzhou, 510006, Guangdong, China
| | - Haibo Zhou
- The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan, 511500, Guangdong, China
| | - Shanwen Lin
- Yangjiang People's Hospital, Yangjiang, 529500, Guangdong, China
| | - Fei Xiao
- Department of Infectious Diseases, Guangdong Provincial Key Laboratory of Biomedical Imaging, Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China
| | - Lu Zhang
- Institute of Infectious Disease, Guangzhou Eighth People's Hospital of Guangzhou Medical University, Guangzhou, 510060, Guangdong, China
| | - Yu Lin
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
| | - Zhaoyong Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Yan Jin
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Fang Zheng
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Wei Chen
- School of Medicine, South China University of Technology, Guangzhou, 510006, Guangdong, China
| | - Airu Zhu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Ye Tao
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
| | - Jingxian Zhao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Tingyou Kuo
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
- BGI Education Center, University of Chinese Academy of Sciences, Shenzhen, 518083, Guangdong, China
| | - Yuming Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Lingguo Li
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
- BGI Education Center, University of Chinese Academy of Sciences, Shenzhen, 518083, Guangdong, China
| | - Liyan Wen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Rijing Ou
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
| | - Fang Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Long Lin
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
- BGI Education Center, University of Chinese Academy of Sciences, Shenzhen, 518083, Guangdong, China
| | - Yanjun Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Jing Sun
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Hao Yuan
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
- BGI Education Center, University of Chinese Academy of Sciences, Shenzhen, 518083, Guangdong, China
| | - Zhen Zhuang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Haixi Sun
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
| | - Zhao Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Jie Li
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
- BGI Education Center, University of Chinese Academy of Sciences, Shenzhen, 518083, Guangdong, China
| | - Jianfen Zhuo
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | | | - Shengnan Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Yuzhe Sun
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
| | - Peilan Wei
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Jinwei Yuan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Tian Xu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Huanming Yang
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
- Guangdong Provincial Academician Workstation of BGI Synthetic Genomics, BGI-Shenzhen, Shenzhen, 518120, China
| | - Jian Wang
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
| | - Xun Xu
- BGI-Shenzhen, Shenzhen, 518083, Guangdong, China
- Guangdong Provincial Key Laboratory of Genome Read and Write, BGI-Shenzhen, Shenzhen, 518120, China
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Yonghao Xu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China.
| | - Kun Sun
- Institute of Cancer Research, Shenzhen Bay Laboratory, Shenzhen, 518132, China.
| | - Jincun Zhao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China.
- Institute of Infectious Disease, Guangzhou Eighth People's Hospital of Guangzhou Medical University, Guangzhou, 510060, Guangdong, China.
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23
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Zhang X, Chen Q, Xu G. Clinical manifestations of COVID-19 infection in dialysis patients and protective effect of COVID-19 vaccine. Inflamm Res 2023; 72:989-1000. [PMID: 37004547 PMCID: PMC10066982 DOI: 10.1007/s00011-023-01723-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/24/2023] [Accepted: 03/20/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVE COVID-19 infection poses a special challenge to patients with dialysis patients. The purpose of this study was to evaluate the clinical manifestations of dialysis patients with COVID-19 and the protective effect of the vaccine. METHODS We included 41 studies based on big data, mainly analyzing the clinical symptoms of dialysis patients with COVID-19, the proportion of severe patients before and after vaccination, and the humoral reaction of vaccine in the body. RESULTS 6.1% to 35.7% of dialysis patients with COVID-19 developed respiratory distress symptoms and needed to be admitted to an intensive care unit for mechanical ventilation. The incidence and mortality of COVID-19 in dialysis patients before vaccination were 5.5% and 1.1%, respectively, and decreased to 4.5% and 0.6% in breakthrough infected patients. There was no statistical difference in serum conversion rates between dialysis patients and healthy controls, but the neutralizing antibody titer in the control group was 1922 (IQR 533 to 3186) AU/mL, and the neutralizing antibody titer in dialysis patients significantly decreased to 367 (IQR 171 to 1650) AU/mL (P=0.046). CONCLUSIONS Dialysis is associated with an increased risk of severe COVID-19, and generally has a poor seroconversion response to vaccines. It also confirms the protective effect of vaccines on high-risk populations such as dialysis.
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Affiliation(s)
- Xuehan Zhang
- Department of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, Nanchang, 330006, People's Republic of China
| | - Qingfeng Chen
- School of Public Health and Management, Nanchang Medical College, No. 1689, Meiling Avenue, Wanli, Nanchang, 330004, People's Republic of China.
| | - Gaosi Xu
- Department of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, Nanchang, 330006, People's Republic of China.
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Wang Z, Ma C. Research on Korean Translation in the Context of Epidemic Prevention and Control. ACM T ASIAN LOW-RESO 2023. [DOI: 10.1145/3589640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
An emergency like COVID-19 requires a theoretical framework for policy implementation that involves public and private sector collaborations. After policy failures, new institutions have formed that trigger PPP's later, allowing the incumbent administration to continue in office longer. It focuses on novel approaches to dealing with pandemics. The present administration put these rules in place to keep COVID-19 under control. When it comes to Real Time - polymerase chain reaction (RT-PCR) testing, South Korea's government and corporations partnered to swiftly raise the quantity of testing in the country. Models of policy change are shown to be dynamic, cyclical, and recursive. During the COVID-19 outbreak in South Korea, an empirical content research was conducted. Even though South Korea's leader was at risk of losing public support to the point where impeachment was mentioned as a possible option, he dramatically reversed public mood to win general elections by a wide margin in April 2020, while the pandemic scenario persisted. To win reelection, democratic administrations are under more pressure to effectively perform crisis management when faced with a crisis. As a result, they are under even more pressure to immediately mobilize public and private resources. The emergency use authorization (EUA) protocol for test kits is an example of "leapfrogging actors" – up-and-coming innovators – who helped turn a pandemic tragedy into a possibility for sustained leadership and for them. The results based on infected premises culling rate ratio is 82.3%, number of measles cases report is 86.4%, spread and epidemic ratio is 84.2%, important of epidemiology is 89.35%, transmission potential of COVID-19 is 91.24% and illustration of epidemic control is 92.45. The results based on infected premises culling rate ratio is 82.3%, number of measles cases report is 86.4%, spread and epidemic ratio is 84.2%, important of epidemiology is 89.35%, transmission potential of COVID-19 is 91.24% and illustration of epidemic control is 92.45.
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Importance of ACE2 for SARS-CoV-2 Infection of Kidney Cells. Biomolecules 2023; 13:biom13030472. [PMID: 36979408 PMCID: PMC10046276 DOI: 10.3390/biom13030472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
In late 2019, the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the causative agent of coronavirus disease 2019 (COVID-19) emerged in China and spread rapidly around the world, causing an ongoing pandemic of global concern. COVID-19 proceeds with moderate symptoms in most patients, whereas others experience serious respiratory illness that requires intensive care treatment and may end in death. The severity of COVID-19 is linked to several risk factors including male sex, comorbidities, and advanced age. Apart from respiratory complications, further impairments by COVID-19 affecting other tissues of the human body are observed. In this respect, the human kidney is one of the most frequently affected extrapulmonary organs and acute kidney injury (AKI) is known as a direct or indirect complication of SARS-CoV-2 infection. The aim of this work was to investigate the importance of the protein angiotensin-converting enzyme 2 (ACE2) for a possible cell entry of SARS-CoV-2 into human kidney cells. First, the expression of the cellular receptor ACE2 was demonstrated to be decisive for viral SARS-CoV-2 cell entry in human AB8 podocytes, whereas the presence of the transmembrane protease serine 2 (TMPRSS2) was dispensable. Moreover, the ACE2 protein amount was well detectable by mass spectrometry analysis in human kidneys, while TMPRSS2 could be detected only in a few samples. Additionally, a negative correlation of the ACE2 protein abundance to male sex and elderly aged females in human kidney tissues was demonstrated in this work. Last, the possibility of a direct infection of kidney tubular renal structures by SARS-CoV-2 was demonstrated.
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26
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Schnabel K, Garam N, Ledó N, Hajdú N, Kóczy Á, Takács I, Tabák ÁG, Tislér A. Urinary albumin-to-creatinine ratio and serum albumin are predictors of acute kidney injury in non-ventilated COVID-19 patients: a single-center prospective cohort study. Int Urol Nephrol 2023; 55:711-720. [PMID: 36127479 PMCID: PMC9488874 DOI: 10.1007/s11255-022-03348-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/19/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Acute kidney injury (AKI) is a frequent complication among COVID-19 patients in the intensive care unit, but it is less frequently investigated in general internal medicine wards. We aimed to examine the incidence, the predictors of AKI, and AKI-associated mortality in a prospective cohort of non-ventilated COVID-19 patients. We aimed to describe the natural history of AKI by describing trajectories of urinary markers of hemodynamic, glomerular, and tubular injury. METHODS 141 COVID-19 patients were enrolled to the study. AKI was defined according to KDIGO guidelines. Urine and renal function parameters were followed twice a week. Multivariate logistic regression was used to determine the predictors of AKI and mortality. Trajectories of urinary markers were described by unadjusted linear mixed models. RESULTS 19.7% patients developed AKI. According to multiple logistic regression, higher urinary albumin-to-creatinine ratio (OR 1.48, 95% CI 1.04-2.12/1 mg/mmol) and lower serum albumin (OR 0.86, 95% CI 0.77-0.94/1 g/L) were independent predictors of AKI. Mortality was 42.8% in the AKI and 8.8% in the group free from AKI (p < 0.0001). According to multiple logistic regression, older age, lower albumin, and AKI (OR 3.9, 95% CI 1.24-12.21) remained independent predictors of mortality. Urinary protein-to-creatinine trajectories were diverging with decreasing values in those without incident AKI. CONCLUSION We found high incidence of AKI and mortality among moderately severe, non-ventilated COVID-19 patients. Its development is predicted by higher albuminuria suggesting that the originally damaged renal structure may be more susceptible for virus-associated effects. No clear relationship was found with a prerenal mechanism, and the higher proteinuria during follow-up may point toward tubular damage.
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Affiliation(s)
- Karolina Schnabel
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, Korányi Sándor utca 2/a, Budapest, 1083, Hungary
| | - Nóra Garam
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, Korányi Sándor utca 2/a, Budapest, 1083, Hungary.
| | - Nóra Ledó
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, Korányi Sándor utca 2/a, Budapest, 1083, Hungary
| | - Noémi Hajdú
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, Korányi Sándor utca 2/a, Budapest, 1083, Hungary
| | - Ágnes Kóczy
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, Korányi Sándor utca 2/a, Budapest, 1083, Hungary
| | - István Takács
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, Korányi Sándor utca 2/a, Budapest, 1083, Hungary
| | - Ádám Gy Tabák
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, Korányi Sándor utca 2/a, Budapest, 1083, Hungary
- Department of Public Health, Semmelweis University Faculty of Medicine, Budapest, Hungary
- Department of Epidemiology and Health Care, University College London, London, UK
| | - András Tislér
- Department of Internal Medicine and Oncology, Semmelweis University Faculty of Medicine, Korányi Sándor utca 2/a, Budapest, 1083, Hungary
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Murali R, Wanjari UR, Mukherjee AG, Gopalakrishnan AV, Kannampuzha S, Namachivayam A, Madhyastha H, Renu K, Ganesan R. Crosstalk between COVID-19 Infection and Kidney Diseases: A Review on the Metabolomic Approaches. Vaccines (Basel) 2023; 11:vaccines11020489. [PMID: 36851366 PMCID: PMC9959335 DOI: 10.3390/vaccines11020489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, a respiratory disorder. Various organ injuries have been reported in response to this virus, including kidney injury and, in particular, kidney tubular injury. It has been discovered that infection with the virus does not only cause new kidney disease but also increases treatment difficulty and mortality rates in people with kidney diseases. In individuals hospitalized with COVID-19, urinary metabolites from several metabolic pathways are used to distinguish between patients with acute kidney injury (AKI) and those without. This review summarizes the pathogenesis, pathophysiology, treatment strategies, and role of metabolomics in relation to AKI in COVID-19 patients. Metabolomics is likely to play a greater role in predicting outcomes for patients with kidney disease and COVID-19 with varying levels of severity in the near future as data on metabolic profiles expand rapidly. Here, we also discuss the correlation between COVID-19 and kidney diseases and the available metabolomics approaches.
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Affiliation(s)
- Reshma Murali
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, Tamil Nadu, India
| | - Uddesh Ramesh Wanjari
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, Tamil Nadu, India
| | - Anirban Goutam Mukherjee
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, Tamil Nadu, India
| | - Abilash Valsala Gopalakrishnan
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, Tamil Nadu, India
- Correspondence: (A.V.G.); (R.G.)
| | - Sandra Kannampuzha
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, Tamil Nadu, India
| | - Arunraj Namachivayam
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, Tamil Nadu, India
| | - Harishkumar Madhyastha
- Department of Cardiovascular Physiology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan
| | - Kaviyarasi Renu
- Center of Molecular Medicine and Diagnostics (COMMAND), Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India
| | - Raja Ganesan
- Institute for Liver and Digestive Diseases, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
- Correspondence: (A.V.G.); (R.G.)
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Puspitasari M, Sattwika PD, Rahari DS, Wijaya W, Hidayat ARP, Kertia N, Purwanto B, Thobari JA. Outcomes of vaccinations against respiratory diseases in patients with end-stage renal disease undergoing hemodialysis: A systematic review and meta-analysis. PLoS One 2023; 18:e0281160. [PMID: 36757979 PMCID: PMC9910685 DOI: 10.1371/journal.pone.0281160] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023] Open
Abstract
Due to the nature of the disease, end-stage renal disease (ESRD) patients suffer from dysfunction of the adaptive immune system, which leads to a poorer response to vaccination. Accordingly, it is crucial to evaluate the efficacy and safety of management strategies, including vaccinations, which could potentially reduce the risk of respiratory diseases, such as pneumonia, influenza, or COVID-19, and its associated outcomes. We searched PubMed, CENTRAL, ScienceDirect, Scopus, ProQuest, and Google Scholar databases using designated MeSH keywords. The risk of bias was assessed using ROBINS-I. The quality of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Relative risk (RR) and 95% confidence interval (CI) were calculated. Heterogeneity was investigated using forest plots and I2 statistics. This systematic review included a total of 48 studies, with 13 studies of influenza (H1N1 and H3N2) vaccination and 35 studies of COVID-19 vaccination. H1N1 vaccination in ESRD patients undergoing hemodialysis induced lower seroconversion rates (RR 0.62, 95% CI: 0.56-0.68, p <0.00001) and lower seroprotection rates (RR 0.76, 95% CI: 0.70-0.83, p <0.00001) compared to controls. H3N2 vaccination in ESRD patients undergoing hemodialysis yielded lower seroconversion rates (RR 0.76, 95% CI: 0.68-0.85, p <0.00001) and lower seroprotection rates (RR 0.84, 95% CI: 0.77-0.90, p <0.00001) compared to controls. Twenty-nine studies demonstrate significantly lower antibody levels in ESRD patients undergoing hemodialysis compared to the controls following COVID-19 vaccination. This review presents evidence of lower seroconversion and seroprotection rates after vaccination against viral respiratory diseases in patients with ESRD undergoing hemodialysis. Since hemodialysis patients are more susceptible to infection and severe disease progression, a weakened yet substantial serological response can be considered adequate to recommend vaccination against respiratory diseases in this population. Vaccination dose, schedule, or strategy adjustments should be considered in stable ESRD patients on maintenance hemodialysis. Trial registration: Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255983, identifier: CRD42021255983.
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Affiliation(s)
- Metalia Puspitasari
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
- * E-mail:
| | - Prenali D. Sattwika
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
- Clinical Epidemiology and Biostatistics Unit, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Dzerlina S. Rahari
- Clinical Epidemiology and Biostatistics Unit, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Wynne Wijaya
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Auliana R. P. Hidayat
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Nyoman Kertia
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Bambang Purwanto
- Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Jarir At Thobari
- Clinical Epidemiology and Biostatistics Unit, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
- Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Muacevic A, Adler JR, Demarchi Foresto R, Machado Proença H, Medina-Pestana J. Two-Hit Kidney Allograft Injury by SARS-CoV-2. Cureus 2023; 15:e34603. [PMID: 36751573 PMCID: PMC9897707 DOI: 10.7759/cureus.34603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has been associated with acute kidney injury in kidney transplant recipients by several mechanisms. The authors report a case of acute kidney allograft dysfunction in a 48-year-old patient who presented in the emergency room with anasarca and nephrotic syndrome close after mild COVID-19 and no other clinical condition. Histopathology of the allograft biopsy revealed two distinct and simultaneous kidney lesions, collapsing glomerulopathy and thrombotic microangiopathy. Renal function persistently deteriorated, and definitive dialysis was initiated. After excluding other plausible causes for the findings, this case strengthens the hypothesis that the kidney allograft is also a target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
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Saygili S, Canpolat N, Cicek RY, Agbas A, Yilmaz EK, Sakalli AAK, Aygun D, Akkoc G, Demirbas KC, Konukoglu D, Cokugras H, Caliskan S, Sever L. Clinical and subclinical acute kidney injury in children with mild-to-moderate COVID-19. Pediatr Res 2023; 93:654-660. [PMID: 35681092 PMCID: PMC9178933 DOI: 10.1038/s41390-022-02124-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/31/2022] [Accepted: 02/24/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Our aim was to identify acute kidney injury (AKI) and subacute kidney injury using both KDIGO criteria and urinary biomarkers in children with mild/moderate COVID-19. METHODS This cross-sectional study included 71 children who were hospitalized with a diagnosis of COVID-19 from 3 centers in Istanbul and 75 healthy children. We used a combination of functional (serum creatinine) and damage (NGAL, KIM-1, and IL-18) markers for the definition of AKI and subclinical AKI. Clinical and laboratory features were evaluated as predictors of AKI and subclinical AKI. RESULTS Patients had significantly higher levels of urinary biomarkers and urine albumin-creatinine ratio than healthy controls (p < 0.001). Twelve patients (16.9%) developed AKI based on KDIGO criteria, and 22 patients (31%) had subclinical AKI. AKI group had significantly higher values of neutrophil count on admission than both subclinical AKI and non-AKI groups (p < 0.05 for all). Neutrophil count was independently associated with the presence of AKI (p = 0.014). CONCLUSIONS This study reveals that even children with a mild or moderate disease course are at risk for AKI. Association between neutrophil count and AKI may point out the role of inflammation in the development of AKI. IMPACT The key message of our article is that not only children with severe disease but also children with mild or moderate disease have an increased risk for kidney injury due to COVID-19. Urinary biomarkers enable the diagnosis of a significant number of patients with subclinical AKI in patients without elevation in serum creatinine. Our findings reveal that patients with high neutrophil count may be more prone to develop AKI and should be followed up carefully. We conclude that even children with mild or moderate COVID-19 disease courses should be evaluated for AKI and subclinical AKI, which may improve patient outcomes.
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Affiliation(s)
- Seha Saygili
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nur Canpolat
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Rumeysa Yasemin Cicek
- Department of Pediatric Nephrology, Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ayse Agbas
- Department of Pediatric Nephrology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Esra Karabag Yilmaz
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ayse Ayzit Kilinc Sakalli
- Department of Pediatric Pulmonology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Deniz Aygun
- Department of Pediatric Infectious Disease, Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gülsen Akkoc
- Department of Pediatric Infectious Disease, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Kaan Can Demirbas
- Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Dildar Konukoglu
- Department of Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Haluk Cokugras
- Department of Pediatric Pulmonology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.,Department of Pediatric Infectious Disease, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Salim Caliskan
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Lale Sever
- Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Role of Renal Parenchyma Attenuation and Perirenal Fat Stranding in Chest CT of Hospitalized Patients with COVID-19. J Clin Med 2023; 12:jcm12030929. [PMID: 36769577 PMCID: PMC9918001 DOI: 10.3390/jcm12030929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Chest CT on coronavirus disease (COVID-19) has been extensively investigated. Acute kidney injury (AKI) has been widely described among COVID patients, but the role of kidney imaging has been poorly explored. The aim of this study is to clarify the role of opportunistic kidney assessment on non-enhanced chest CT. METHODS We collected data on patients with COVID-19 consecutively admitted to our institution who underwent chest CT (including the upper parts of kidneys as per protocol). Three ROIs of 0.5-0.7 cm2 were positioned in every kidney. The values of renal parenchyma attenuation (RPA) and the presence of perirenal fat stranding (PFS) were analyzed. The primary and secondary outcomes were the occurrence of AKI and death. RESULTS 86 patients with COVID-19 and unenhanced chest CT were analyzed. The cohort was split into CT RPA quartiles. Patients with a CT RPA <24 HU were more likely to develop AKI when compared with other patients (χ2 = 2.77, p = 0.014): at multivariate logistic regression analysis, being in the first quartile of CT RPA was independently associated with a four times higher risk of AKI (HR 4.56 [95% CI 1.27-16.44, p = 0.020). Within a mean 22 ± 15 days from admission, 32 patients died (37.2%). Patients with PFS were more likely to die as compared to patients without it (HR 3.90 [95% CI 1.12-13.48], p = 0.031). CONCLUSIONS Detection of low RPA values and of PFS in COVID-19 patients independently predicts, respectively, the occurrence of AKI and an increased risk for mortality. Therefore, opportunistic kidney assessment during chest CT could help physicians in defining diagnostic and therapeutic strategies.
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Effects of self-management education on COVID-19 prevention in patients undergoing hemodialysis. Heliyon 2023; 9:e12931. [PMID: 36644679 PMCID: PMC9831661 DOI: 10.1016/j.heliyon.2023.e12931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/12/2023] Open
Abstract
Aim To develop self-management education for preventing coronavirus disease 2019 (COVID-19) in patients on hemodialysis and to verify its effects. Background During the current pandemic, studies on various areas, such as infection control in dialysis units, infection rates, clinical characteristics, treatment progress, and the emotional and psychological states of dialysis patients, have been actively reported. However, experimental research verifying the effects of interventions on infection prevention in hemodialysis patients is very rare. Methods This study included 34 patients on hemodialysis in a South Korean general hospital (18 in the experimental group and 16 in the control group). Data were collected from September to October 2021. The experimental group was provided with self-care behavior for infection prevention education for 8 weeks, and the control group was provided with usual nursing care. Results The patients on hemodialysis showed moderate fear of COVID-19, good compliance with patient role behavior and self-management efficacy, and poor handwashing practice. After the intervention, there were no significant differences concerning fear of COVID-19, compliance with patient role behavior, and self-management efficacy between the experimental and control groups. However, confidence in handwashing (subjective norm) and proper handwashing practice improved significantly in the experimental group compared with the control group. Conclusion The infection prevention education developed in this study positively affected confidence in handwashing and proper handwashing practice in patients undergoing hemodialysis. This intervention can be used in various clinical settings where care is provided for patients with chronic illness, including those on hemodialysis.
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Double glomerulopathies or two-faced janus? A challenging case in the COVID-19 era. J Nephrol 2023; 36:225-228. [PMID: 35666373 PMCID: PMC9169020 DOI: 10.1007/s40620-022-01351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/10/2022] [Indexed: 02/07/2023]
Abstract
SARS-CoV-2 very often causes kidney involvement through various mechanisms including: acute tubular injury, virus cell invasion, vascular damage due to hypercoagulability and finally dysregulation of the immune system. Even though there are no pathognomonic morphologic features that can rule out or confirm direct damage by SARS-CoV-2, the latest literature suggests that there may be some association. SARS-CoV-2 infection represents a poor prognostic factor, regardless of pulmonary involvement. We report a challenging case with complex renal biopsy findings suggestive of collapsing glomerulopathy and focal proliferative IgA-dominant glomerulonephritis in a patient affected by active hepatitis C virus (HCV), SARS-CoV-2 infection and personal history of cocaine abuse.
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COVID-19 and renal involvement: a prospective cohort study assessing the impact of mild SARS-CoV-2 infection on the kidney function of young healthy males. Int Urol Nephrol 2023; 55:201-209. [PMID: 35877031 PMCID: PMC9310686 DOI: 10.1007/s11255-022-03301-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 07/07/2022] [Indexed: 01/08/2023]
Abstract
PURPOSE COVID-19 frequently affects the kidneys with symptoms ranging from mild proteinuria to progressive acute kidney injury. This prospective study aimed to assess the short- and long-term impact of asymptomatic and mild COVID-19 on the renal function of healthy young adults, and to determine the correlation between viral load and kidney function among these patients. METHODS This was a prospective cohort study conducted over a period of 6 months. Patients were followed-up at baseline, and then after 3 and 6 months, respectively. Real-time PCR cycle threshold (CT) was used to determine the viral load and disease activity. Patients were classified into two groups with either asymptomatic COVID-19 or mild pneumonia. The assessment parameters were variables that could directly or indirectly relate to the renal function. RESULTS A total of 48 patients were included and evaluated. The majority of patients (62.5%) had asymptomatic COVID-19 disease. Patients with mild pneumonia had significantly higher serum creatinine (SCr) at the time of COVID-19 diagnosis (beta = 12.836, 95% CI = 2.405-23.268, P = 0.019), after 3 months (beta = 14.345, 95% CI = 1.149-27.542, P = 0.035), and after 6 months (beta = 14.100, 95% CI = 0.730-27.470, P = 0.040) compared to asymptomatic patients. Mild pneumonia was also significantly associated with lower serum albumin level at the time of COVID-19 diagnosis (beta = - 6.317, 95% CI = - 9.448-- 3.185, P < 0.001). CONCLUSION Mild COVID-19 is associated with mild renal involvement without AKI. Changes in the renal function appear to be related to reduced creatinine clearance and possible albumin leakage in the acute phase of the disease. The reduction in creatinine clearance is not predicted by viral load, and it appears to be a long-term effect of the disease that can last for at least 6 months.
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Roberts SH, Goodwin ML, Bobba CM, Al-Qudsi O, Satyapriya SV, Tripathi RS, Papadimos TJ, Whitson BA. Continuous renal replacement therapy and extracorporeal membrane oxygenation: implications in the COVID-19 era. Perfusion 2023; 38:18-27. [PMID: 34494489 DOI: 10.1177/02676591211042561] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The novel severe acute respiratory syndrome coronavirus 2, SARS-CoV-2 (coronavirus Disease 19 (COVID-19)) was identified as the causative agent of viral pneumonias in Wuhan, China in December 2019, and has emerged as a pandemic causing acute respiratory distress syndrome (ARDS) and multiple organ dysfunction. Interim guidance by the World Health Organization states that extracorporeal membrane oxygenation (ECMO) should be considered as a rescue therapy in COVID-19-related ARDS. International registries tracking ECMO in COVID-19 patients reveal a 21%-70% incidence of acute renal injury requiring renal replacement therapy (RRT) during ECMO support. The indications for initiating RRT in patients on ECMO are similar to those for patients not requiring ECMO. RRT can be administered during ECMO via a temporary dialysis catheter, placement of a circuit in-line hemofilter, or direct connection of continuous RRT in-line with the ECMO circuit. Here we review methods for RRT during ECMO, RRT initiation and timing during ECMO, anticoagulation strategies, and novel cytokine filtration approaches to minimize COVID-19's pathophysiological impact.
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Affiliation(s)
- Sophia H Roberts
- Division of Cardiac Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,The Ohio State University College of Medicine, Columbus, OH, USA
| | - Matthew L Goodwin
- Division of Cardiac Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Christopher M Bobba
- Division of Cardiac Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,The Ohio State University College of Medicine, Columbus, OH, USA
| | - Omar Al-Qudsi
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - S Veena Satyapriya
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Ravi S Tripathi
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Thomas J Papadimos
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Bryan A Whitson
- Division of Cardiac Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Salman H, Al-Khero Z, Al-Aziz Yousif Z, Thanoon A. The consequences of severe acute respiratory syndrome coronavirus-2 on acute kidney injury among iraqi patients. BIOMEDICAL AND BIOTECHNOLOGY RESEARCH JOURNAL (BBRJ) 2023. [DOI: 10.4103/bbrj.bbrj_353_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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37
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Said KB, Alsolami A, Alreshidi FS, Fathuddin A, Alshammari F, Alrashid F, Aljadani A, Aboras R, Alreshidi F, Alghozwi MH, Alshammari SF, Alharbi NF. Profiles of Independent-Comorbidity Groups in Senior COVID-19 Patients Reveal Low Fatality Associated with Standard Care and Low-Dose Hydroxychloroquine over Antivirals. J Multidiscip Healthc 2023; 16:1215-1229. [PMID: 37153358 PMCID: PMC10162097 DOI: 10.2147/jmdh.s403700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction The lack of feasible therapies and comorbidities aggravate the COVID-19 case-fatality rate (CFR). However, reports examining CFR associations with diabetes, concomitant cardiovascular diseases, chronic kidney disease, and chronic liver disease (CLD) are limited. More studies assessing hydroxychloroquine (Hcq) and antivirals are needed. Purpose To examine associations of COVID-19 CFR in comorbid patient groups each with single comorbidities and after treatment with Hcq, favipiravir, and dexamethasone (Dex), either alone or in combination versus standard care. Methods Using statistical analysis, we descriptively determined these associations among 750 COVID-19 patient groups during the last quarter of 2021. Results A diabetes comorbidity (40%, n=299) showed twice the fatality (CFR 14%) of the others (CFR 7%; P=0.001). Hypertension (Htn) was the second-commonest comorbidity (29.5%, n=221), with similar CFR to diabetes (15% and 7% for Htn and non-Htn, respectively), but with higher significance (P=0.0006167). Although only 4% (n=30) heart failure (HF) was reported, the CFR (40%) was much higher than in those without it (8%). A similar rate (4%) for chronic kidney disease was reported, with CFRs of 33% and 9% among those with and without it, respectively (P=0.00048). Ischemic heart disease was 11% (n=74), followed by chronic liver disease (0.4%) and history of smoking (1%); however, these were not significant due to the sample sizes. Treatment indicated standard care and Hcq alone or in combination were superior (CFR of 4% and 0.5%, respectively) compared to favipiravir (25%) or Dex (38.5%) independently or in combination (35.4%). Furthermore, Hcq performed well (CFR 9%) when combined with Dex (9%; P=4.28-26). Conclusion The dominance of diabetes and other comorbidities with significant association with CFR implied existence of a common virulence mechanism. The superiority of low-dose Hcq and standard care over antivirals warrants further studies.
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Affiliation(s)
- Kamaleldin B Said
- Department of Pathology and Microbiology, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
- Genomics, Bioinformatics and Systems Biology, Carleton University, Ottawa, ON K1S 5B6, Canada
- Correspondence: Kamaleldin B Said, Department of Pathology and Microbiology, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia, Tel +966500771459, Email
| | - Ahmed Alsolami
- Department of Internal Medicine, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Fayez Saud Alreshidi
- Deparmtent of Family, Community Medicine, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Anas Fathuddin
- Department of Plastic Surgery, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Fawwaz Alshammari
- Department of Dermatology, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Fauwaz Alrashid
- Department of Surgery, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Ahmed Aljadani
- Department of Internal Medicine, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Rana Aboras
- Deparmtent of Family, Community Medicine, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Fatmah Alreshidi
- Deparmtent of Family, Community Medicine, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Mohammed H Alghozwi
- Department of Pathology and Microbiology, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Suliman F Alshammari
- Department of Pathology and Microbiology, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
| | - Nawaf F Alharbi
- Department of Pathology and Microbiology, College of Medicine, University of Ha’il, Ha’il, 55476, Saudi Arabia
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Bozkir CDC, Ozmemis C, Kurbanzade AK, Balcik B, Gunes ED, Tuglular S. Capacity planning for effective cohorting of hemodialysis patients during the coronavirus pandemic: A case study. EUROPEAN JOURNAL OF OPERATIONAL RESEARCH 2023; 304:276-291. [PMID: 34744293 PMCID: PMC8556688 DOI: 10.1016/j.ejor.2021.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 10/20/2021] [Indexed: 05/09/2023]
Abstract
Planning treatments of different types of patients have become challenging in hemodialysis clinics during the COVID-19 pandemic due to increased demands and uncertainties. In this study, we address capacity planning decisions of a hemodialysis clinic, located within a major public hospital in Istanbul, which serves both infected and uninfected patients during the COVID-19 pandemic with limited resources (i.e., dialysis machines). The clinic currently applies a 3-unit cohorting strategy to treat different types of patients (i.e., uninfected, infected, suspected) in separate units and at different times to mitigate the risk of infection spread risk. Accordingly, at the beginning of each week, the clinic needs to allocate the available dialysis machines to each unit that serves different patient cohorts. However, given the uncertainties in the number of different types of patients that will need dialysis each day, it is a challenge to determine which capacity configuration would minimize the overlapping treatment sessions of different cohorts over a week. We represent the uncertainties in the number of patients by a set of scenarios and present a stochastic programming approach to support capacity allocation decisions of the clinic. We present a case study based on the real-world patient data obtained from the hemodialysis clinic to illustrate the effectiveness of the proposed model. We also compare the performance of different cohorting strategies with three and two patient cohorts.
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Affiliation(s)
- Cem D C Bozkir
- Industrial Engineering Department, Ozyegin University, Istanbul, Turkey
| | - Cagri Ozmemis
- Industrial Engineering Department, Ozyegin University, Istanbul, Turkey
| | | | - Burcu Balcik
- Industrial Engineering Department, Ozyegin University, Istanbul, Turkey
| | - Evrim D Gunes
- Business Administration, College of Administrative Sciences and Economics, Koc University, Sariyer, Istanbul, Turkey
| | - Serhan Tuglular
- Medical Faculty, Department of Internal Medicine, Marmara University, Istanbul, Turkey
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Zhang W, Liu L, Xiao X, Zhou H, Peng Z, Wang W, Huang L, Xie Y, Xu H, Tao L, Nie W, Yuan X, Liu F, Yuan Q. Identification of common molecular signatures of SARS-CoV-2 infection and its influence on acute kidney injury and chronic kidney disease. Front Immunol 2023; 14:961642. [PMID: 37026010 PMCID: PMC10070855 DOI: 10.3389/fimmu.2023.961642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 03/07/2023] [Indexed: 04/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the main cause of COVID-19, causing hundreds of millions of confirmed cases and more than 18.2 million deaths worldwide. Acute kidney injury (AKI) is a common complication of COVID-19 that leads to an increase in mortality, especially in intensive care unit (ICU) settings, and chronic kidney disease (CKD) is a high risk factor for COVID-19 and its related mortality. However, the underlying molecular mechanisms among AKI, CKD, and COVID-19 are unclear. Therefore, transcriptome analysis was performed to examine common pathways and molecular biomarkers for AKI, CKD, and COVID-19 in an attempt to understand the association of SARS-CoV-2 infection with AKI and CKD. Three RNA-seq datasets (GSE147507, GSE1563, and GSE66494) from the GEO database were used to detect differentially expressed genes (DEGs) for COVID-19 with AKI and CKD to search for shared pathways and candidate targets. A total of 17 common DEGs were confirmed, and their biological functions and signaling pathways were characterized by enrichment analysis. MAPK signaling, the structural pathway of interleukin 1 (IL-1), and the Toll-like receptor pathway appear to be involved in the occurrence of these diseases. Hub genes identified from the protein-protein interaction (PPI) network, including DUSP6, BHLHE40, RASGRP1, and TAB2, are potential therapeutic targets in COVID-19 with AKI and CKD. Common genes and pathways may play pathogenic roles in these three diseases mainly through the activation of immune inflammation. Networks of transcription factor (TF)-gene, miRNA-gene, and gene-disease interactions from the datasets were also constructed, and key gene regulators influencing the progression of these three diseases were further identified among the DEGs. Moreover, new drug targets were predicted based on these common DEGs, and molecular docking and molecular dynamics (MD) simulations were performed. Finally, a diagnostic model of COVID-19 was established based on these common DEGs. Taken together, the molecular and signaling pathways identified in this study may be related to the mechanisms by which SARS-CoV-2 infection affects renal function. These findings are significant for the effective treatment of COVID-19 in patients with kidney diseases.
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Affiliation(s)
- Weiwei Zhang
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
| | - Leping Liu
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Xiangcheng Xiao
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
| | - Hongshan Zhou
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
| | - Zhangzhe Peng
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
- Organ Fibrosis Key Lab of Hunan Province, Central South University, Changsha, China
| | - Wei Wang
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
- Organ Fibrosis Key Lab of Hunan Province, Central South University, Changsha, China
| | - Ling Huang
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
- Organ Fibrosis Key Lab of Hunan Province, Central South University, Changsha, China
| | - Yanyun Xie
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
- Organ Fibrosis Key Lab of Hunan Province, Central South University, Changsha, China
| | - Hui Xu
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
- Organ Fibrosis Key Lab of Hunan Province, Central South University, Changsha, China
| | - Lijian Tao
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
- Organ Fibrosis Key Lab of Hunan Province, Central South University, Changsha, China
| | - Wannian Nie
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
| | - Xiangning Yuan
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
- Organ Fibrosis Key Lab of Hunan Province, Central South University, Changsha, China
| | - Fang Liu
- Health Management Center, Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Fang Liu, ; Qiongjing Yuan,
| | - Qiongjing Yuan
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
- Organ Fibrosis Key Lab of Hunan Province, Central South University, Changsha, China
- National Clinical Medical Research Center for Geriatric Diseases, Xiangya Hospital of Central South University, Changsha, China
- Research Center for Medical Metabolomics, Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Fang Liu, ; Qiongjing Yuan,
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Babazadeh Z. Involvement of NLRP3 Inflammasome in SARS-Cov-2-Induced Multiorgan Dysfunction in Patients with COVID-19: A Review of Molecular Mechanisms. TANAFFOS 2023; 22:40-52. [PMID: 37920322 PMCID: PMC10618576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 07/13/2022] [Indexed: 11/04/2023]
Abstract
Nucleotide-binding domain and leucine-rich repeat protein- 3 (NLRP3) inflammasome is a critical component of the innate immune system. The inflammasome activation is correlated with the COVID- 19 severity. Furthermore, the underlying conditions are accompanied by hyperactivation of NLRP3 inflammasome and poor outcomes. Herein, we presented the involvement of NLRP3 inflammasome in the pathogenies of SARS-CoV-2-induced multiorgan dysfunction and potential therapeutics. Overexpression of NLRP3 inflammasome components and subsequently increased levels of cytokines following viral infection leads to the cytokine storm and indirectly affects the organ functions. Besides, invading host cells via SARS-CoV-2 further activates the NLRP3 inflammasome and induces pyroptosis in immune cells, resulting in the secretion of higher levels of proinflammatory cytokines into the extracellular matrix. These events continued by induction of fibrosis and organ dysfunction following infection with SARS-CoV-2 in critically ill patients. This condition can be observed in individuals with comorbidities (e.g., diabetes, obesity, etc.) due to a primed state of immunity, which can cause severe disease or death in this population. Therefore, understanding the mechanisms underlying host-SARS-CoV-2 interaction may help to clarify the pathophysiology of SARS-CoV-2- induced multiorgan dysfunction and introduce potential therapeutic strategies.
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Affiliation(s)
- Zahra Babazadeh
- Department of Anatomical Science, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
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Evaluation of the relationship between acute kidney injury and renin angiotensin system inhibition in COVID-19 patients. North Clin Istanb 2022; 9:541-549. [PMID: 36685627 PMCID: PMC9833383 DOI: 10.14744/nci.2022.87360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/12/2022] [Accepted: 09/28/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE In patients with coronavirus disease 2019 (COVID-19), acute kidney injury (AKI) may alter the clinical course and outcome of the disease. In this study, the association of AKI with renin angiotensin system (RAS) inhibitor treatment and its clinical consequences were examined in COVID-19 patients admitted to our hospital during the initial stages of the pandemic. METHODS A total of 407 patients between 18 and 85 years of age (202 male and 205 female) admitted to the Umraniye Research And Training Hospital between May 2020 and August 2020 with a diagnosis of COVID-19 were included in the study. Patients were categorized as follows: Group 1, subjects with no chronic conditions (n=150); and Group 2, subjects with comorbid conditions (n=257). Group 2 was subdivided into Group 2A (receiving angiotensin receptor blocker [ARB])/(angiotensin converting enzyme inhibitor [ACEI], n=81), and Group 2B (not receiving ARB/ACEI, n=176). RESULTS Hypertension was the most frequent comorbid condition (36.4%). There was no difference in survival rates between the patients who used RAS inhibitor and the ones who did not based on log rank test (p=0.342). Fifty-four patients (13.4%) had developed AKI during the time frame of the disease. In patients with chronic diseases such as hypertension, the use of RAS inhibitory medication was not associated with developing AKI (OR 95% CI: 0.317-1.358; p=0.256). The survival rate of the patients with AKI was significantly lower than patients without AKI (p<0.0001). CONCLUSION COVID-19 may cause renal injury represents a risk factor for mortality. Therefore, detection of renal injury has a particular prognostic importance.
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Highly pathogenic coronaviruses and the kidney. Biomed Pharmacother 2022; 156:113807. [PMID: 36242850 PMCID: PMC9550661 DOI: 10.1016/j.biopha.2022.113807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/01/2022] [Accepted: 10/03/2022] [Indexed: 12/15/2022] Open
Abstract
Since the end of 2019, the outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has triggered a pneumonia epidemic, posing a significant public health challenge in 236 countries, territories, and regions worldwide. Clinically, in addition to the symptoms of pulmonary infection, many patients with SARS-CoV-2 infections, especially those with a critical illness, eventually develop multiple organ failure in which damage to the kidney function is common, ultimately leading to severe consequences such as increased mortality and morbidity. To date, three coronaviruses have set off major global public health security incidents: Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), Middle East Respiratory Syndrome Coronavirus (MERS-CoV), and SARS-CoV-2. Among the diseases caused by the coronaviruses, the coronavirus disease 2019 (COVID-19) has been the most impactful and harmful. Similar to with SARS-CoV-2 infections, previous studies have shown that kidney injury is also common and prominent in patients with the two other highly pathogenic coronaviruses. Therefore, in this review, we aimed to comprehensively summarize the epidemiological and clinical characteristics of these three pandemic-level infections, provide a deep analysis of the potential mechanism of COVID-19 in various types of kidney diseases, and explore the causes of secondary kidney diseases of SARS-CoV-2, so as to provide a reference for further research and the clinical prevention of kidney damage caused by coronaviruses.
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Ahmed N, Khderat AH, Sarsour A, Taher A, Hammoudi A, Hamdan Z, Nazzal Z. The vulnerability of maintenance dialysis patients with COVID-19: mortality and risk factors from a developing country. Ann Med 2022; 54:1511-1519. [PMID: 35594312 PMCID: PMC9132419 DOI: 10.1080/07853890.2022.2075914] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Patients on maintenance dialysis therapy are especially vulnerable to COVID-19 and its complications. This study aimed to assess the incidence, epidemiological characteristics, and mortality rate of COVID-19 among maintenance dialysis patients. This retrospective observational chart review study included 548 patients from all dialysis units in the West Bank of Palestine who acquired COVID-19 between 5 March 2020, and 11 August 2021. We collected data on patients' demographics, clinical features, and outcomes. A multivariable logistic regression model was used to assess independent risk factors for COVID-19-related mortality. The incidence of COVID-19 among maintenance dialysis patients was 35.3%, as 548 out of 1554 patients have tested positive during the study period. Patients on haemodialysis were three times riskier to get infected than those on peritoneal dialysis (37% vs 11.3%). Half (50.2%) of infected patients required hospitalisation, and 24.5% were admitted to an intensive care unit, while the mortality rate stood at 26.8%. Old age, male sex, central venous catheter use, comorbid diabetes, smoking, and having an RH negative blood group type were determined to be significantly associated with increased risk of mortality. In conclusion, the incidence of COVID-19 among Palestinian maintenance dialysis patients was notably high, especially among haemodialysis patients. High rates of hospitalisation, ICU admission, intubation and death were observed, and predictive factors for COVID-19-related mortality were identified. Therefore, the implementation of strict infection control measures and promotion of home dialysis are warranted to reduce the infection rate.KEY MESSAGESThe incidence of COVID-19 among Palestinian maintenance dialysis patients was notably high; more than one-third of the total dialysis population acquired COVID-19, with haemodialysis patients being three times more likely to get infected compared to their peritoneal dialysis counterparts.The mortality rate among maintenance dialysis patients was 26.8%, more than 25 times higher than that of the general population. The risk of mortality was significantly increased with age, male sex, smoking, diabetes, and having central venous catheter as vascular access for haemodialysis.Strict infection control measures, as well as the promotion of home dialysis, are necessary to reduce the risk of infection.
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Affiliation(s)
- Nabil Ahmed
- Registered Nurse, Kidney and Dialysis Section, An-Najah National University Hospital, Nablus, Palestine
| | - Abdel Hadi Khderat
- Registered Nurse, Kidney and Dialysis Section, An-Najah National University Hospital, Nablus, Palestine
| | - Alaa Sarsour
- Registered Nurse, Kidney and Dialysis Section, An-Najah National University Hospital, Nablus, Palestine
| | - Ameed Taher
- Jenin Government Hospital, Palestinian Ministry of Health, Jenin, Palestine
| | - Ahmad Hammoudi
- Kidney and Dialysis Section, Department of Internal Medicine, An-Najah National University Hospital, Nablus, Palestine
| | - Zakaria Hamdan
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Zaher Nazzal
- Department of Family and Community Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Endothelial Dysfunction in COVID-19: Potential Mechanisms and Possible Therapeutic Options. LIFE (BASEL, SWITZERLAND) 2022; 12:life12101605. [PMID: 36295042 PMCID: PMC9604693 DOI: 10.3390/life12101605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/29/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
SARS-CoV-2, a novel coronavirus found in Wuhan (China) at the end of 2019, is the etiological agent of the current pandemic that is a heterogeneous disease, named coronavirus disease 2019 (COVID-19). SARS-CoV-2 affects primarily the lungs, but it can induce multi-organ involvement such as acute myocardial injury, myocarditis, thromboembolic eventsandrenal failure. Hypertension, chronic kidney disease, diabetes mellitus and obesity increase the risk of severe complications of COVID-19. There is no certain explanation for this systemic COVID-19 involvement, but it could be related to endothelial dysfunction, due to direct (endothelial cells are infected by the virus) and indirect damage (systemic inflammation) factors. Angiotensin-converting enzyme 2 (ACE2), expressed in human endothelium, has a fundamental role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In fact, ACE2 is used as a receptor by SARS-CoV-2, leading to the downregulation of these receptors on endothelial cells; once inside, this virus reduces the integrity of endothelial tissue, with exposure of prothrombotic molecules, platelet adhesion, activation of coagulation cascades and, consequently, vascular damage. Systemic microangiopathy and thromboembolism can lead to multi-organ failure with an elevated risk of death. Considering the crucial role of the immunological response and endothelial damage in developing the severe form of COVID-19, in this review, we will attempt to clarify the underlying pathophysiological mechanisms.
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Cuevas‐Budhart MÁ, Celaya Pineda IX, Perez Moran D, Trejo Villeda MA, Gomez del Pulgar M, Rodríguez Zamora MC, Ramos‐Sanchez A, Paniagua Sierra J. Patient experience in automated peritoneal dialysis with telemedicine monitoring during the COVID-19 pandemic in Mexico: Qualitative study. Nurs Open 2022; 10:1092-1101. [PMID: 36229915 PMCID: PMC9834531 DOI: 10.1002/nop2.1377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 06/09/2022] [Accepted: 09/04/2022] [Indexed: 01/13/2023] Open
Abstract
AIM The aim of the study was to understand the experiences of patients on automated peritoneal dialysis (APD) during the period of confinement due to the COVID-19 pandemic. DESIGN Qualitative exploratory study, phenomenological through semi-structured telephone interview. METHOD A priori sampling was carried out with patients on APD with remote monitoring and telephone follow-up, in 13 hospitals in Mexico. RESULTS Twenty-nine informants, mean age 45.41 ± 16.93; 15 women and 14 men. The analysis revealed four categories of analysis: home isolation, clinical follow-up, socioeconomic challenges and infodemic. The experiences of these patients led them to somatize emotions, presenting symptoms such as anxiety, sadness, loneliness, sleep, eating and digestive disorders, situation that sets the tone for future research on telemedicine care models, coping styles, emotional support strategies and socioeconomic impact on patients with chronic home treatments during the pandemic.
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Affiliation(s)
- Miguel Ángel Cuevas‐Budhart
- Unidad de investigación Médica en Enfermedades Nefrológicas, CMN Siglo XXIInstituto Mexicano del Seguro SocialMexico CityMexico
| | | | - Diana Perez Moran
- Unidad de Investigación de Epidemiologia en Servicios de SaludCMN Siglo XXI. Instituto Mexicano del Seguro SocialMexico CityMexico
| | | | | | | | - Alfonso Ramos‐Sanchez
- CEO. Innovación y tecnología al servicio de la saludMacrotechSanto DomingoDominican Republic
| | - Jose Ramón Paniagua Sierra
- Unidad de investigación Médica en Enfermedades Nefrológicas, CMN Siglo XXIInstituto Mexicano del Seguro SocialMexico CityMexico
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Shahidi S, Vahdat S, Atapour A, Reisizadeh S, Soltaninejad F, Maghami-Mehr A. The clinical course and risk factors in COVID-19 patients with acute kidney injury. J Family Med Prim Care 2022; 11:6183-6189. [PMID: 36618164 PMCID: PMC9810939 DOI: 10.4103/jfmpc.jfmpc_231_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/28/2022] [Accepted: 05/17/2022] [Indexed: 11/11/2022] Open
Abstract
Background Acute kidney injury (AKI) has the most prevalent complications in COVID-19 patients. A variety of factors is involved in the disease progression and its associated outcomes. The present study aimed at both examining the correlated clinical features of COVID-19 disease and AKI and evaluating its clinical outcomes. Materials and Methods In the present retrospective study, 102 COVID-19 patients that encountered AKI were enrolled and categorized into three AKI stages. Basic and clinical characteristics, clinical signs and symptoms, laboratory and imaging findings, and treatment approaches were examined. Then, clinical outcomes as well as the factors associated with the mortality of patients were evaluated. Results Diabetes was the only significant clinical characteristic among the patients (P = 0.004). An increasing trend was observed for neutrophil-to-lymphocyte ratio (P = 0.027) and potassium (K) (P = 0.006), and a decreasing trend was seen for hemoglobin (P < 0.001), albumin (P = 0.005), and calcium (P < 0.001) factors at higher stages of AKI. Secondary infection (P = 0.019) and hypoproteinemia (P = 0.018) were the most significant clinical outcomes. Chronic obstructive lung disease (OR = 1.362, P = 0.007), renal replacement therapy (OR = 2.067, P = 0.005), lung consolidation (OR = 0.722, P = 0.032), and bilateral pulmonary infiltration (OR = 4.793, P = 0.002) were the factors associated with mortality rate of COVID-19 patients with AKI. Conclusion AKI, as an important complication of COVID-19, that can predict the higher mortality rate as well as the laboratory and clinical characteristics should receive more due consideration in order to employ proper preventive or supportive treatment approaches that are the pivotal key to reduce the mortality rate in target patients.
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Affiliation(s)
- Shahrzad Shahidi
- Department of Nephrology, Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Vahdat
- Department of Nephrology, Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Sahar Vahdat, Assistant Professor of Nephrology, Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
| | - Abdolamir Atapour
- Department of Nephrology, Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shadi Reisizadeh
- Department of Internal Medicine, Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Forogh Soltaninejad
- Associate Professor of Pulmonary Diseases, Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Silva BM, Assis LCSD, Batista MDC, Gonzalez NAP, Anjos SBD, Goes MA. Acute kidney injury outcomes in covid-19 patients: systematic review and meta-analysis. J Bras Nefrol 2022; 44:543-556. [PMID: 35848725 PMCID: PMC9838673 DOI: 10.1590/2175-8239-jbn-2022-0013en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/03/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Acute kidney injury (AKI) is a frequent complication of coronavirus-19 disease (COVID-19). Therefore, we decided to perform a systematic review and meta-analysis with data from the literature to relate the development of COVID-19 associated-AKI with comorbidities, medications, and the impact of mechanical ventilation. METHODS We performed a systematic review using the Newcastle-Ottawa scale and a meta-analysis using the R program. Relevant studies were searched in the PubMed, Medline, and SciELO electronic databases. Search filters were used to include reports after 2020 and cohort studies. RESULTS In total, 1166 articles were identified and 55 English-written articles were included based on the risk of bias. Of all COVID-19-hospitalized patients presenting with AKI (n = 18029) classified as Kidney Disease Improving Global Outcomes stage 1 to 3, approximately 18% required mechanical ventilation and 39.2 % died. Around 11.3% of the patients required kidney replacement therapy (KRT) and of these, 1093 died and 321 required continuous KRT. Death is more frequent in individuals with AKI [OR 6.03, 95%CI: 5.73-6.74; p<0.01]. Finally, mechanical ventilation is an aggravating factor in the clinical conditions studied [OR 11.01, 95%CI: 10.29-11.77; p<0.01]. CONCLUSION Current literature indicates AKI as an important complication in COVID-19. In this context, we observed that comorbidities, such as chronic kidney disease and heart failure, were more related to the development of AKI. In addition, mechanical ventilation was seen as an aggravating factor in this scenario.
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Vaccination and COVID-19 in Polish Dialysis Patients: Results from the European Clinical Dialysis Database. Vaccines (Basel) 2022; 10:vaccines10091565. [PMID: 36146642 PMCID: PMC9505069 DOI: 10.3390/vaccines10091565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/28/2022] Open
Abstract
Background: Patients with end-stage kidney disease undergoing hemodialysis are particularly vulnerable to severe COVID-19 as a result of older age and multimorbidities. Objectives: Data are still limited and there are no published data on mortality in hemodialyzed patients in Poland, in particular when vaccines became available. We assessed the epidemiologic and clinical data of patients with laboratory-confirmed COVID-19 and assessed the mortality in 2019, 2020, and 2021, as well as the vaccination rate in 2021. Patients and Methods: Retrospectively collected data from 73 Fresenius Nephrocare Poland hemodialysis centers and one public unit were analyzed. Results: In 2021, the vaccination rate was 96%. The unadjusted mortality (number of deaths divided by number of patients) in 2019 was 18.8%, while the unadjusted (after exclusion of COVID-related deaths) mortality in 2020 was 20.8%, and mortality in 2021 was 16.22%. The prevalence of cardiovascular deaths in 2019 and 2020 was almost identical (41.4% vs. 41.2%, respectively), and in 2021, the figures increased slightly to 44.1%. The prevalence of sudden cardiac deaths in 2019 was higher than in 2020 (19.6% vs. 17.3%, respectively) and consequently decreased in 2021 (10.0%), as well as strokes (6.2% vs. 5.4%, and 3.31% in 2021), whereas deaths due to gastrointestinal tract diseases were lower (2.5% vs. 3.2%, and 2.25% in 2021), diabetes complications (0.5% vs. 1.3%, and 0.5% in 2021), sepsis (5.1% vs. 6.3%, and 8.79% in 2021), respiratory failure (1.2 vs. 1.6%, and 2.83% in 2021), and pneumonia (1.4% vs. 2.0%, and 0.82%). There were 1493 hemodialyzed COVID-19 positive patients, and among them, 191 died in 2020 (12.79%). In 2021, there were 1224 COVID-19 positive patients and 260 died (21.24%). The mortality of COVID-19 positive dialyzed patients contributed 13.39% in 2020 and 16.21% in 2021 of all recorded deaths. Conclusions: The mortality among HD patients was higher in 2021 than in 2020 and 2019, despite the very high vaccination rate of up to 96%. The higher non-COVID-19 mortality may be due to the limited possibility of hospitalization and dedicated care during the pandemic. This information is extremely important in order to develop methods to protect this highly vulnerable patient group. Prevention plays a key role; other measures are essential in the mitigation and spread of COVID-19 in HD centers.
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da Silva SJR, do Nascimento JCF, Germano Mendes RP, Guarines KM, Targino Alves da Silva C, da Silva PG, de Magalhães JJF, Vigar JRJ, Silva-Júnior A, Kohl A, Pardee K, Pena L. Two Years into the COVID-19 Pandemic: Lessons Learned. ACS Infect Dis 2022; 8:1758-1814. [PMID: 35940589 PMCID: PMC9380879 DOI: 10.1021/acsinfecdis.2c00204] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible and virulent human-infecting coronavirus that emerged in late December 2019 in Wuhan, China, causing a respiratory disease called coronavirus disease 2019 (COVID-19), which has massively impacted global public health and caused widespread disruption to daily life. The crisis caused by COVID-19 has mobilized scientists and public health authorities across the world to rapidly improve our knowledge about this devastating disease, shedding light on its management and control, and spawned the development of new countermeasures. Here we provide an overview of the state of the art of knowledge gained in the last 2 years about the virus and COVID-19, including its origin and natural reservoir hosts, viral etiology, epidemiology, modes of transmission, clinical manifestations, pathophysiology, diagnosis, treatment, prevention, emerging variants, and vaccines, highlighting important differences from previously known highly pathogenic coronaviruses. We also discuss selected key discoveries from each topic and underline the gaps of knowledge for future investigations.
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Affiliation(s)
- Severino Jefferson Ribeiro da Silva
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil.,Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada
| | - Jessica Catarine Frutuoso do Nascimento
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
| | - Renata Pessôa Germano Mendes
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
| | - Klarissa Miranda Guarines
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
| | - Caroline Targino Alves da Silva
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
| | - Poliana Gomes da Silva
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
| | - Jurandy Júnior Ferraz de Magalhães
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil.,Department of Virology, Pernambuco State Central Laboratory (LACEN/PE), 52171-011 Recife, Pernambuco, Brazil.,University of Pernambuco (UPE), Serra Talhada Campus, 56909-335 Serra Talhada, Pernambuco, Brazil.,Public Health Laboratory of the XI Regional Health, 56912-160 Serra Talhada, Pernambuco, Brazil
| | - Justin R J Vigar
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada
| | - Abelardo Silva-Júnior
- Institute of Biological and Health Sciences, Federal University of Alagoas (UFAL), 57072-900 Maceió, Alagoas, Brazil
| | - Alain Kohl
- MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, United Kingdom
| | - Keith Pardee
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada.,Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON M5S 3G8, Canada
| | - Lindomar Pena
- Laboratory of Virology and Experimental Therapy (LAVITE), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
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Bartolomeo CS, Lemes RMR, Morais RL, Pereria GC, Nunes TA, Costa AJ, de Barros Maciel RM, Braconi CT, Maricato JT, Janini LMR, Okuda LH, Lee KS, Prado CM, Ureshino RP, Stilhano RS. SARS-CoV-2 infection and replication kinetics in different human cell types: The role of autophagy, cellular metabolism and ACE2 expression. Life Sci 2022; 308:120930. [PMID: 36075471 PMCID: PMC9444585 DOI: 10.1016/j.lfs.2022.120930] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 11/19/2022]
Abstract
Aims This study evaluated SARS-CoV-2 replication in human cell lines derived from various tissues and investigated molecular mechanisms related to viral infection susceptibility and replication. Main methods SARS-CoV-2 replication in BEAS-2B and A549 (respiratory tract), HEK-293 T (kidney), HuH7 (liver), SH-SY5Y (brain), MCF7 (breast), Huvec (endothelial) and Caco-2 (intestine) was evaluated by RT-qPCR. Concomitantly, expression levels of ACE2 (Angiotensin Converting Enzyme) and TMPRSS2 were assessed through RT-qPCR and western blot. Proteins related to autophagy and mitochondrial metabolism were monitored in uninfected cells to characterize the cellular metabolism of each cell line. The effect of ACE2 overexpression on viral replication in pulmonary cells was also investigated. Key findings Our data show that HuH7, Caco-2 and MCF7 presented a higher viral load compared to the other cell lines. The increased susceptibility to SARS-CoV-2 infection seems to be associated not only with the differential levels of proteins intrinsically related to energetic metabolism, such as ATP synthase, citrate synthase, COX and NDUFS2 but also with the considerably higher TMPRSS2 mRNA expression. The two least susceptible cell types, BEAS-2B and A549, showed drastically increased SARS-CoV-2 replication capacity when ACE2 was overexpressed. These modified cell lines are relevant for studying SARS-CoV-2 replication in vitro. Significance Our data not only reinforce that TMPRSS2 expression and cellular energy metabolism are important molecular mechanisms for SARS-CoV-2 infection and replication, but also indicate that HuH7, MCF7 and Caco-2 are suitable models for mechanistic studies of COVID-19. Moreover, pulmonary cells overexpressing ACE2 can be used to understand mechanisms associated with SARS-CoV-2 replication.
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Affiliation(s)
- Cynthia Silva Bartolomeo
- Department of Physiological Sciences, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil; Department of Biosciences, Universidade Federal de São Paulo, Santos, SP, Brazil
| | - Robertha Mariana Rodrigues Lemes
- Department of Biological Sciences, Universidade Federal de São Paulo, Diadema, SP, Brazil; Laboratory of Molecular and Translational Endocrinology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Rafael Leite Morais
- Department of Biophysics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gabriela Cruz Pereria
- Department of Biochemistry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Tamires Alves Nunes
- Department of Biosciences, Universidade Federal de São Paulo, Santos, SP, Brazil
| | - Angelica Jardim Costa
- Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Rui Monteiro de Barros Maciel
- Department of Biological Sciences, Universidade Federal de São Paulo, Diadema, SP, Brazil; Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Carla Torres Braconi
- Department of Microbiology Immunology and Parasitology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Juliana Terzi Maricato
- Department of Microbiology Immunology and Parasitology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Luiz Mario Ramos Janini
- Department of Microbiology Immunology and Parasitology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Liria Hiromi Okuda
- Instituto Biológico, Secretaria de Agricultura e Abastecimento, São Paulo, SP, Brazil
| | - Kil Sun Lee
- Department of Biochemistry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Carla Máximo Prado
- Department of Biosciences, Universidade Federal de São Paulo, Santos, SP, Brazil
| | - Rodrigo Portes Ureshino
- Department of Biological Sciences, Universidade Federal de São Paulo, Diadema, SP, Brazil; Laboratory of Molecular and Translational Endocrinology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Roberta Sessa Stilhano
- Department of Physiological Sciences, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.
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