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• W3113452977 abstract "Background: Since the emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), most of the focus has been on the respiratory failure caused by the resulting disease, COVID-19 However, the effects of COVID-19 in the kidney are increasingly recognized Acute kidney injury (AKI) has been identified with varying prevalence around the world with higher rates (37-46%) reported in the USA It is debatable whether AKI is an indirect consequence of systemic inflammation or a consequence of viral renal cell infection and tropism We hypothesize that SARSCoV- 2 directly infects kidney tissue and increases the risk of developing AKI, worsening prognosis of COVID-19 patients Methods: We studied 88 COVID-19 patients admitted to the Henry Ford Hospital, Detroit after April 15, 2020 Demographics were: mean age 60, 71% African American, 55% male We quantified viral copies by RT-PCR (S and N genes) in urine sediments from 52 PCR-confirmed COVID-19 patients We performed immunofluorescence for Membrane and Spike viral proteins in two COVID-19 biopsies Results: The prevalence of AKI was 72%, with 32% of patients admitted to the ICU The overall mortality rate was 14%, with no deaths in non-AKI patients Viral proteins M and S were detected in the glomerulus, parietal cells and tubules of COVID-19 patients In some tubules, positive SARS-CoV-2 overlapped with ACE2, the receptor for viral entry Virus was detected in 61% of urine sediments, with 6-fold greater viral load in AKIpatient urines (copies/ng RNA: AKI, 7422±1338 vs No-AKI: 1523 ± 404;p<0 05, n=52) The highest viral loads were detected three weeks post-AKI at 11,374±2248 copies/ng RNA (p<0 01) Among COVID-19 AKI-patients who died, the urine viral load exceeded 8000 copies/ng RNA Above this threshold, the mortality rate was 55% Conclusions: Our data support that direct viral renal cell infection occurs in COVID-19 AKI patients with urinary viral genome detection Greater urinary viral loads portend increased mortality Urinary viral detection can facilitate management and treatment of COVID-19 and improve outcomes Future research should focus on studying whether urine contains infective virus or sheds non-infective genomic fragments" @default.
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• W3113452977 date "2020-01-01" @default.
• W3113452977 modified "2023-09-26" @default.
• W3113452977 title "SARS-CoV-2 receptor networks in diabetic kidney disease, BK virus nephropathy, and COVID-19 associated AKI" @default.
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