Kidney injury in COVID-19 patients, drug development and their renal complications: Review study - 18/09/21

Abstract |
Since December 2019, the world was encountered a new disease called coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although SARS-CoV-2 initially causes lung damage, it also affects many other organs, including the kidneys, and on average, 5–23% of people with COVID-19 develop the symptoms of acute kidney injury (AKI), including elevated blood creatinine and urea, hematuria, proteinuria, and histopathological damages. The exact mechanism is unknown, but the researchers believe that SARS-CoV-2 directly and indirectly affects the kidneys. The direct pathway is by binding the virus to ACE2 receptor in the kidney, damage to cells, the renin-angiotensin system disturbances, activating coagulation pathways, and damaging the renal vascular endothelium. The initial evidence from studying the kidney tissue in postmortem patients is more in favor of the direct pathway. The indirect pathway is created by increased cytokines and cytokine storm, sepsis, circulatory disturbances, hypoxemia, as well as using the nephrotoxic drugs. Using renal tissue biopsy and autopsy in the patients with COVID-19, recent studies found evidence for a predominant indirect pathway in AKI induction by SARS-CoV-2. Besides, some studies showed that the degree of acute tubular injury (ATI) in autopsies from COVID-19 victims is milder compared to AKI degree. We review the mechanism of AKI induction and the renal side effects of the most common drugs used to treat COVID-19 after the overview of the latest findings on SARS-CoV-2 pathogenicity.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | SARS-CoV-2 may directly and/or indirectly affect the kidneys. |
• | The direct pathway is by binding to ACE2 in the kidney and damage to cells. |
• | An indirect pathway is created by cytokine storm and using nephrotoxic drugs. |
• | ATI degree in COVID-19 victim's autopsies is milder than the degree of AKI. |
• | Likely several factors play a role in developing AKI following COVID-19. |
Keywords : SARS-CoV-2, COVID-19, Acute kidney injury, ACE2, Histopathologic damages
Plan
Vol 142
Article 111966- octobre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.