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评估尿液 SARS-COV-2 RT-PCR 作为危重症 COVID-19 患者急性肾损伤和疾病严重程度的预测指标。

Evaluation of urine SARS-COV-2 RT-PCR as a predictor of acute kidney injury and disease severity in patients with critical COVID-19.

机构信息

Nefrology Service, São Rafael Hospital, Salvador, Brazil.

Internal Medicine, Hospital Santo Antônio, Salvador, Brazil.

出版信息

J Int Med Res. 2021 May;49(5):3000605211015555. doi: 10.1177/03000605211015555.

Abstract

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which began as an outbreak in Wuhan, China and has spread rapidly across the globe. Although most infections are mild, patients with severe and critical COVID-19 infections face deterioration of respiratory function and may also have extrapulmonary manifestations, mostly affecting the kidney, digestive tract, heart, and nervous system. Here, we prospectively evaluated the presence of SARS-CoV-2 genetic material using reverse-transcription polymerase chain reaction in urine samples obtained from patients with COVID-19 receiving critical care. Among 51 included patients, we found higher serum creatinine levels, a longer hospital stay, and more frequent need for dialysis in urine-positive patients. These findings could suggest that, in predisposed patients, a direct viral cytopathic effect may contribute to a more severe disease phenotype.

摘要

2019 冠状病毒病(COVID-19)是由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的新发传染病,最初在中国武汉暴发,现已迅速在全球蔓延。尽管多数感染为轻症,但重症和危重症 COVID-19 感染患者的呼吸功能会恶化,且可能出现肺外表现,主要影响肾脏、消化道、心脏和神经系统。在此,我们前瞻性评估了采用逆转录聚合酶链反应(reverse-transcription polymerase chain reaction)在接受重症监护的 COVID-19 患者的尿液样本中是否存在 SARS-CoV-2 遗传物质。在纳入的 51 例患者中,我们发现尿液阳性患者的血清肌酐水平更高,住院时间更长,需要透析的频率更高。这些发现表明,在易感患者中,病毒的直接细胞病变效应可能导致更严重的疾病表型。

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本文引用的文献

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Acute kidney injury in patients hospitalized with COVID-19.COVID-19 住院患者中的急性肾损伤。
Kidney Int. 2020 Jul;98(1):209-218. doi: 10.1016/j.kint.2020.05.006. Epub 2020 May 16.
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J Am Soc Nephrol. 2020 Jun;31(6):1157-1165. doi: 10.1681/ASN.2020030276. Epub 2020 Apr 28.
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The Novel Coronavirus 2019 epidemic and kidneys.2019新型冠状病毒疫情与肾脏
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