Ojha Pushpanjali R, Kumar Rakesh
Department of Pathology, Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, India.
Assistant Professor, Department of Emergency Medicine, HiTech Medical College and Hospital, Rourkela, Odisha, India.
J Cytol. 2024 Jan-Mar;41(1):34-40. doi: 10.4103/joc.joc_102_23. Epub 2023 Dec 28.
"Intraepithelial inclusions on urinalysis screening among COVID-19 cases: Are they -A hospital-based cohort study with narrative review."
Coronavirus disease 2019 (COVID-19)-associated delayed acute kidney injury (AKI) is often reported in subsequent waves of the pandemic. Early intervention and regular follow-up influence the outcome and inhibit progression into chronic kidney disease (CKD). This is the first study to identify urinary cytomorphological abnormalities () and predict COVID-19-associated delayed AKI with a narrative review of the possible etiologies for intraepithelial inclusions.
A hospital-based cohort study with a narrative review.
Screening urinalysis to assess the cytomorphology of epithelial cells (ECs) and inclusions in Leishman and periodic acid-Schiff (PAS)-stained smears by two independent pathologists was performed in reverse transcriptase polymerase chain reaction (RT-PCR)-confirmed COVID-19 cases at a tertiary care center.
Basic statistical tools were used for descriptive statistical analysis, and data were expressed in mean, proportion, and frequency.
Cytomorphological abnormalities (48/188) were predominant among adult males. Leukocyturia (39/48) with positive nitrite test (28/39), high ECs (27/48) and squamous cell-to-tubular EC (SC:TEC) ratio, intraepithelial intracytoplasmic inclusions predominantly in TECs (), and multiple well-visualized, perinuclear PAS-negative neutrophilic vacuoles (17/39) were found. The association with preexisting diabetes (31/48), hypertension (10/48), and disease severity was noted.
This study reported COVID-19-associated urinary cytomorphological abnormalities and interesting unique inclusions () that may be a result of underlying inflammatory changes, reactive hyperplasia, degenerative changes, or defective endocytosed vacuoles. The possible etiologies for renal inclusions were reviewed. We recommend compulsory baseline and follow-up urinary cytology screening for all COVID-19-suspected patients to detect and predict delayed AKI before clinical and biochemical manifestation during disease endemicity.
“COVID-19病例尿液分析筛查中的上皮内包涵体：它们是——一项基于医院的队列研究及叙述性综述”
2019冠状病毒病（COVID-19）相关的延迟性急性肾损伤（AKI）在疫情的后续浪潮中经常被报道。早期干预和定期随访会影响预后并抑制其进展为慢性肾脏病（CKD）。这是第一项通过对上皮内包涵体的可能病因进行叙述性综述来识别尿液细胞形态学异常并预测COVID-19相关延迟性AKI的研究。
一项基于医院的队列研究及叙述性综述。
在一家三级医疗中心，对经逆转录聚合酶链反应（RT-PCR）确诊的COVID-19病例进行尿液分析筛查，由两名独立病理学家评估利什曼染色和过碘酸希夫（PAS）染色涂片上皮细胞（ECs）的细胞形态及包涵体情况。
使用基本统计工具进行描述性统计分析，数据以均值、比例和频率表示。
细胞形态学异常（48/188）在成年男性中占主导。发现有白细胞尿（39/48）且亚硝酸盐试验阳性（28/39）、高ECs（27/48）以及鳞状细胞与肾小管EC（SC:TEC）比值，上皮内胞质内包涵体主要见于肾小管ECs（），还有多个清晰可见的核周PAS阴性嗜中性空泡（17/39）。注意到其与既往糖尿病（31/48）、高血压（10/48）及疾病严重程度的关联。
本研究报告了COVID- related尿液细胞形态学异常以及有趣的独特包涵体（）现象，这可能是潜在炎症变化、反应性增生、退行性变化或内吞空泡缺陷的结果。对肾脏包涵体的可能病因进行了综述。我们建议对所有疑似COVID-19患者进行强制性基线和随访尿液细胞学筛查，以便在疾病流行期间临床和生化表现出现之前检测和预测延迟性AKI。
