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Lin L, Li L, Cao Y, Peng X, Wu Y, Yu P, Dong L. The expression of respiratory tract virus in pediatric glomerular disease: a retrospective study of 45 renal biopsy in China. BMC Nephrol 2023; 24:36. [PMID: 36792980 PMCID: PMC9931563 DOI: 10.1186/s12882-023-03083-8] [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: 03/23/2022] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND More attention has been put on the relationship between pediatric glomerular disease and respiratory tract virus infection. Children with glomerular illness, however, are uncommonly found to have biopsy-proven pathological evidence of viral infection. The purpose of this study is to determine whether and what kind of respiratory viruses are found in renal biopsy from glomerular disorders. METHODS We used a multiplex PCR to identify a wide range of respiratory tract viruses in the renal biopsy samples (n = 45) from children with glomerular disorders and a specific PCR to verify their expression. RESULTS These case series included 45 of 47 renal biopsy specimens, with 37.8% of male and 62.2% of female patients. Indications for a kidney biopsy were present in all of the individuals. In 80% of the samples, respiratory syncytial virus was discovered. Following that, the RSV subtypes in several pediatric renal disorders were found. There were 16 RSVA positives, 5 RSVB positives, and 15 RSVA/B positives, accounting for 44.4%, 13.9%, and 41.7%, respectively. Nephrotic syndrome samples made up 62.5% of RSVA positive specimens. The RSVA/B-positive was detected in all pathological histological types. CONCLUSIONS Patients with glomerular disease exhibit respiratory tract viral expression in the renal tissues, especially respiratory syncytial virus. This research offers new information on the detection of respiratory tract viruses in renal tissue, which may facilitate the identification and treatment of pediatric glomerular diseases.
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Affiliation(s)
- Li Lin
- grid.461863.e0000 0004 1757 9397Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, 610041 Sichuan Province China
| | - Lu Li
- grid.13291.380000 0001 0807 1581National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, No. 17, Section 3, South Renmin Road, Chengdu, 610041 Sichuan Province China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No. 17, Section 3, South Renmin Road, Chengdu, 610041 Sichuan Province China
| | - Yao Cao
- grid.461863.e0000 0004 1757 9397Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, 610041 Sichuan Province China
| | - Xin Peng
- grid.461863.e0000 0004 1757 9397Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, 610041 Sichuan Province China
| | - Yi Wu
- grid.461863.e0000 0004 1757 9397Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, 610041 Sichuan Province China
| | - Ping Yu
- National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, No. 17, Section 3, South Renmin Road, Chengdu, 610041, Sichuan Province, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, No. 17, Section 3, South Renmin Road, Chengdu, 610041, Sichuan Province, China.
| | - LiQun Dong
- Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, 610041, Sichuan Province, China.
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Medeiros T, Alves LS, Cabral-Castro MJ, Silva ARO, Xavier AR, Burger D, Almeida JR, Silva AA. Exploring Urinary Extracellular Vesicles and Immune Mediators as Biomarkers of Kidney Injury in COVID-19 Hospitalized Patients. Diagnostics (Basel) 2022; 12:diagnostics12112600. [PMID: 36359444 PMCID: PMC9689919 DOI: 10.3390/diagnostics12112600] [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: 09/05/2022] [Revised: 10/11/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022] Open
Abstract
Kidney injury is an important outcome associated with COVID-19 severity. In this regard, alterations in urinary extracellular vesicles (uEVs) could be detected in the early phases of renal injury and may be reflective of the inflammatory process. This is an observational study performed with a case series of COVID-19 hospitalized patients presenting mild-to-critical disease. Total and podocyte-derived uEVs were identified by nanoscale flow cytometry, and urinary immune mediators were assessed by a multiplex assay. We studied 36 patients, where 24 (66.7%) were considered as mild/moderate and 12 (33.3%) as severe/critical. Increased levels of total uEVs were observed (p = 0.0001). Importantly, total uEVs were significantly higher in severe/critical patients who underwent hemodialysis (p = 0.03) and were able to predict this clinical outcome (AUC 0.93, p = 0.02). Severe/critical patients also presented elevated urinary levels (p < 0.05) of IL-1β, IL-4, IL-6, IL-7, IL-16, IL-17A, LIF, CCL-2, CCL-3, CCL-11, CXCL-10, FGFb, M-CSF, and CTAcK. Lastly, we observed that total uEVs were associated with urinary immune mediators. In conclusion, our results show that early alterations in urinary EVs could identify patients at higher risk of developing renal dysfunction in COVID-19. This could also be relevant in different scenarios of systemic and/or infectious disease.
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Affiliation(s)
- Thalia Medeiros
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences (LAMAP), Faculty of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Rio de Janeiro, Brazil
- Department of Pathology, Faculty of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Rio de Janeiro, Brazil
- Correspondence: (T.M.); (A.A.S.); Tel.: +55-21-3674-7282 (A.A.S.)
| | - Lilian Santos Alves
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences (LAMAP), Faculty of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Rio de Janeiro, Brazil
| | - Mauro Jorge Cabral-Castro
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences (LAMAP), Faculty of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Rio de Janeiro, Brazil
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-901, Rio de Janeiro, Brazil
| | - Alice Ramos Oliveira Silva
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences (LAMAP), Faculty of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Rio de Janeiro, Brazil
| | - Analúcia Rampazzo Xavier
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences (LAMAP), Faculty of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Rio de Janeiro, Brazil
- Department of Pathology, Faculty of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Rio de Janeiro, Brazil
| | - Dylan Burger
- Kidney Research Centre, Department of Cellular and Molecular Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Jorge Reis Almeida
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences (LAMAP), Faculty of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Rio de Janeiro, Brazil
- Department of Clinical Medicine; Faculty of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Rio de Janeiro, Brazil
| | - Andrea Alice Silva
- Multiuser Laboratory for Research Support in Nephrology and Medical Sciences (LAMAP), Faculty of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Rio de Janeiro, Brazil
- Department of Pathology, Faculty of Medicine, Universidade Federal Fluminense, Niterói 24033-900, Rio de Janeiro, Brazil
- Correspondence: (T.M.); (A.A.S.); Tel.: +55-21-3674-7282 (A.A.S.)
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Kalita P, Dey B, Mishra J, Tiewsoh I, Raphael V. Immunoglobulin A Nephropathy in a SARS-CoV-2-Positive Patient With Coexistent Metabolic Syndrome. Cureus 2022; 14:e28719. [PMID: 36204032 PMCID: PMC9527633 DOI: 10.7759/cureus.28719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 12/28/2022] Open
Abstract
SARS-CoV-2 viral infection though primarily affects the respiratory system, but concurrent renal involvement is been reported in the medical literature. Acute kidney injury (AKI) is a common finding in SARS-CoV-2-positive patients. An isolated case of IgA nephropathy in a SARS-CoV-2 virus-infected patient has been already reported in the medical literature. Incidence of metabolic syndromes is on the rise considering the change in lifestyle and food habits and the global pandemic of obesity. Renal manifestations of metabolic syndrome are myriad with IgA nephropathy being an occasional manifestation in such patients. We reported a case of IgA nephropathy in a patient in her fourth decade of life diagnosed as metabolic syndrome with concomitant SARS-CoV-2 infection that progressed to chronic kidney damage (CKD) subsequently. In this case report, we postulate that cytokine storm along with hypoxemia secondary to SARS-CoV-2 infection may accelerate the declining renal function however further studies are necessary to confirm this hypothesis considering the rarity of such cases.
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COVID-19 in Coincidence with Transient Distal Renal Tubular Acidosis in an Infant. Case Rep Infect Dis 2022; 2022:5361305. [PMID: 35669099 PMCID: PMC9166963 DOI: 10.1155/2022/5361305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/22/2022] [Indexed: 11/20/2022] Open
Abstract
Background Post-COVID-19 nephropathies have been reported profusely in the literature with diverse pathophysiological mechanisms. To the best of our knowledge, this is the first report of transient distal (type 1) renal tubular acidosis (dRTA) in an infant with confirmed COVID-19. Case Presentation. We describe a 32-day-old female with diarrhea and fever without respiratory complaints. Her weight, height, and head circumference were normal for age. The primary lab test showed leukocytosis, neutrophilia, elevated inflammatory markers, and non-anion-gap metabolic acidosis. Real-time polymerase chain reaction (RT-PCR) and elevated SARS-CoV-2 immunoglobulin M confirmed COVID-19, while echocardiography and spiral chest computed tomography scan were normal. Intravenous fluid therapy and supportive care were initiated. Blood culture was positive for Klebsiella pneumoniae. Amikacin and cefotaxime were ordered. Although diarrhea and dehydration gradually improved, venous blood gas still showed metabolic acidosis. Due to the alkaline urine and hypokalemic-hyperchloremic metabolic acidosis, dRTA was diagnosed. Notably, the patient dramatically responded to Shohl's solution. Conclusions Regarding the various manifestations of COVID-19, the possible association between dRTA and COVID-19 needs further investigation in children.
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Copur S, Berkkan M, Basile C, Tuttle K, Kanbay M. Post-acute COVID-19 syndrome and kidney diseases: what do we know? J Nephrol 2022; 35:795-805. [PMID: 35294747 PMCID: PMC8924729 DOI: 10.1007/s40620-022-01296-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 02/20/2022] [Indexed: 12/17/2022]
Abstract
COVID-19, a disease caused by a novel coronavirus (SARS-CoV-2), is a major global threat that has turned into a pandemic. Despite the emergence of multiple vaccination alternatives and developing therapeutic options, dramatic short- and long-term clinical outcomes have been recorded with more than 250 million infected people and over 5 million deaths as of November 2021. COVID-19 presents various respiratory, cardiovascular, neuropsychiatric, musculoskeletal and kidney features during the acute phase; nevertheless, renal involvement in the post-infection period has recently been emphasized. The present review aims to evaluate the growing literature on kidney involvement in the SARS-CoV-2 infection along with clinical features reported both in the acute phase of the infection and in the post-acute COVID-19 period by assessing potential pathophysiological frameworks explaining such conditions. Chronic kidney disease and development of acute kidney injury (AKI) in the course of initial hospitalization are associated with high mortality and morbidity rates. Moreover, growing evidence suggests a decline in renal function in the 6-to-12-month follow-up period even in patients without any signs of AKI during the acute phase. Despite such concerns there are no guidelines regulating the follow-up period or therapeutic alternatives for such patient population. In conclusion, the burden of COVID-19 on the kidney is yet to be determined. Future prospective large scale studies are needed with long follow-up periods assessing kidney involvement via multiple parameters such as biopsy studies, urinalysis, measurement of serum creatinine and cystatin C, directly measured glomerular filtration rate, and assessment of tubular function via urinary β2-microglobulin measurements.
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Affiliation(s)
- Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Metehan Berkkan
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Carlo Basile
- Associazione Nefrologica Gabriella Sebastio, Martina Franca, Italy
| | - Katherine Tuttle
- Division of Nephrology, University of Washington, Seattle, WA USA
- Providence Medical Research Center, Providence Health Care, Washington, USA
| | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
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Zarei M, Bose D, Nouri-Vaskeh M, Tajiknia V, Zand R, Ghasemi M. Long-term side effects and lingering symptoms post COVID-19 recovery. Rev Med Virol 2021; 32:e2289. [PMID: 34499784 PMCID: PMC8646420 DOI: 10.1002/rmv.2289] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/10/2021] [Accepted: 08/13/2021] [Indexed: 12/12/2022]
Abstract
Since the Coronavirus disease 2019 (COVID‐19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), our understanding regarding the pathophysiology and clinical manifestations of this disease have been improving. However, we still have limited data on long‐term effects and lingering symptoms of post COVID‐19 recovery. Despite predilection of COVID‐19 for lungs, multiple extra‐pulmonary manifestations appear in multiple organs and biological systems and with continued infection and recovery worldwide. It is necessary that clinicians provide patients with previous SARS‐CoV‐2 infection with expectations of long‐term effects during or after recovery from COVID‐19. Herein, we review the long‐term impact of COVID‐19 on different organ systems reported from different clinical studies. Understanding risk factors and signs and symptoms of long‐term consequences after recovery from COVID‐19 will allow for proper follow‐up and management of the disease post recovery.
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Affiliation(s)
- Mohammad Zarei
- Renal Division, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,John B. Little Center for Radiation Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Deepanwita Bose
- New Iberia Research Center, University of Louisiana at Lafayette, New Iberia, Louisiana, USA
| | - Masoud Nouri-Vaskeh
- Tropical and Communicable Diseases Research Centre, Iranshahr University of Medical Sciences, Iranshahr, Iran.,Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network, Tehran, Iran
| | - Vida Tajiknia
- Department of Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ramin Zand
- Department of Neurology, Neuroscience Institute, Geisinger Health System, Danville, Pennsylvania, USA
| | - Mehdi Ghasemi
- Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Hassani K, Errihani M, Mahamoud MH, ElKabbaj D. Membranoproliferative Glomerulonephritis following the Oxford AstraZeneca COVID-19 Vaccine. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2021; 32:1831-1832. [DOI: 10.4103/1319-2442.352451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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