Clin Nephrol. 2021 May;95(5):227-239. doi: 10.5414/CN110357.
The presentation of kidney damage in Coronavirus disease 2019 (COVID-19) varies significantly. According to recent studies, the development of acute kidney injury (AKI) in severe cases of COVID-19 infection significantly worsens the prognosis of these patients. The pathological changes in kidneys might be caused directly by the cytopathic effect mediated by local replication of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) or indirectly because of systemic immune response or hypercoagulation, so-called immunothrombosis. Other causes, such as hypovolemia and hypoxia, may also contribute to AKI. Acute kidney disease often develops in elderly patients with underlying comorbidities or in critically ill patients with severe respiratory failure. It is known that AKI is a risk factor for mortality in COVID-19 patients.
在 2019 冠状病毒病(COVID-19)中,肾脏损害的表现差异很大。根据最近的研究,严重 COVID-19 感染患者发生急性肾损伤(AKI)显著恶化了这些患者的预后。肾脏的病理变化可能是由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的局部复制介导的细胞病变效应直接引起,也可能是由于全身免疫反应或高凝状态,即所谓的免疫血栓形成引起。其他原因,如低血容量和缺氧,也可能导致 AKI。急性肾疾病常发生在有潜在合并症的老年患者或有严重呼吸衰竭的重症患者中。已知 AKI 是 COVID-19 患者死亡的一个危险因素。