Open AccessCOVID 19 and acute kidney injury
Author(s) -
Narayan Prasad,
Sanjay Agrawal
Publication year - 2020
Publication title -
indian journal of nephrology/indian journal of nephrology
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 24
eISSN - 1998-3662
pISSN - 0971-4065
DOI - 10.4103/ijn.ijn_120_20
Subject(s) - medicine , cytokine storm , acute kidney injury , pneumonia , diffuse alveolar damage , sepsis , coronavirus , respiratory system , middle east respiratory syndrome , respiratory tract , middle east respiratory syndrome coronavirus , immunology , lung , covid-19 , disease , infectious disease (medical specialty) , acute respiratory distress
Coronavirus disease 19 (COVID-19) is caused by severe acute respiratory syndrome-corona virus (SARS-CoV-2), a beta coronavirus, mainly involves the respiratory tract, and the clinical features simulate to a severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) of the past. The genome of the SARS-CoV-2, isolated from a cluster-patient with a typical pneumonia after visiting Wuhan, had 89% nucleotide identitical with bat SARS-like-CoVZXC21 and 82% with that of human SARS-CoV. It enters the respiratory tract through angiotensin converting enzyme-2 (ACE2) receptors on alveoli. It may induce lung injury through direct cytopathic effect, involving effector T cells or causing sepsis and inducing cytokine storm. With a similar mechanism, it can cause acute kidney injury (AKI). The overall incidence of AKI is 5.1%, and AKI is an independent risk factor for mortality. The hazard ratio of death increases with the increasing severity of AKI. Management of COVID-19 with AKI is primarily supportive care, and at present, there are no evidence based effective antivirals for the treatment.