Singh Vishwajeet, Singh Mukul Kumar
Department of Urology, King George's Medical University, Lucknow, UP 226003 India.
Indian J Surg. 2021 Apr;83(2):398-402. doi: 10.1007/s12262-020-02697-8. Epub 2021 Apr 23.
The contemporary evolution of the coronavirus disease 2019 (COVID-19) outbreak from the Wuhan, China, with a high rate of transmission will act the global medical emergency with immense morbidity and mortality rate across the world. The cell entry of COVID-19 via angiotensin-converting enzyme 2 receptor (ACE-2 receptor) will damage the respiratory system by the cytopathic effect induced by replication of the virus genome in the host and respond respiratory failure with an elevation of cytokine factor-like interleukin (IL) IL-6, IL-8, tumor necrosis factor-alpha (TNF-alpha), etc. However, the lung-kidney cross talk will evidence the activation of molecular mechanisms from pro-inflammatory cytokines and concerned with kidney damage, though the elevated rate of ACE-2 receptor in the kidney will enhance the possibility of mortality with consideration of acute kidney injury. This review provides relevant information which suggests the rate of mortality in COVID-19 patient associated with acute kidney injury (AKI) which lacks critical monitoring of kidney function with a clinical consideration of intervention to avoid kidney damage in the initial stage of the disease.
2019年冠状病毒病(COVID-19)在中国武汉爆发并具有高传播率,这一疫情的当代演变将成为一场全球医疗紧急事件,在全球范围内造成极高的发病率和死亡率。COVID-19通过血管紧张素转换酶2受体(ACE-2受体)进入细胞,会因病毒基因组在宿主细胞中复制所诱导的细胞病变效应而损害呼吸系统,并引发呼吸衰竭,同时细胞因子如白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)等水平会升高。然而,肺-肾相互作用将证明促炎细胞因子相关分子机制的激活以及与肾损伤有关,尽管肾脏中ACE-2受体水平升高会因急性肾损伤而增加死亡可能性。本综述提供了相关信息,表明COVID-19患者中与急性肾损伤(AKI)相关的死亡率,而该疾病缺乏对肾功能的关键监测,临床上需要考虑在疾病初期进行干预以避免肾损伤。