COVID-19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup

Nature Reviews Nephrology, Journal Year: 2020, Volume and Issue: 16(12), P. 747 - 764

Published: Oct. 15, 2020

Abstract Kidney involvement in patients with coronavirus disease 2019 (COVID-19) is common, and can range from the presence of proteinuria haematuria to acute kidney injury (AKI) requiring renal replacement therapy (RRT; also known as therapy). COVID-19-associated AKI (COVID-19 AKI) associated high mortality serves an independent risk factor for all-cause in-hospital death COVID-19. The pathophysiology mechanisms COVID-19 have not been fully elucidated seem be multifactorial, keeping other who are critically ill. Little about prevention management AKI. emergence regional ‘surges’ cases limit hospital resources, including dialysis availability supplies; thus, careful daily assessment available resources needed. In this Consensus Statement, Acute Disease Quality Initiative provides recommendations diagnosis, based on current literature. We make areas future research, which aimed at improving understanding underlying processes outcomes

Language: Английский

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Placental Pathology in COVID-19

American Journal of Clinical Pathology, Journal Year: 2020, Volume and Issue: 154(1), P. 23 - 32

Published: May 16, 2020

Abstract Objectives To describe histopathologic findings in the placentas of women with coronavirus disease 2019 (COVID-19) during pregnancy. Methods Pregnant COVID-19 delivering between March 18, 2020, and May 5, were identified. Placentas examined compared to historical controls placental evaluation for a history melanoma. Results Sixteen from patients severe acute respiratory syndrome 2 (SARS-CoV-2) (15 live birth third trimester, 1 delivered second trimester after intrauterine fetal demise). Compared controls, significantly more likely show at least one feature maternal vascular malperfusion (MVM), particularly abnormal or injured vessels, intervillous thrombi. Rates chronic inflammation not increased. The placenta patient demise showed villous edema retroplacental hematoma. Conclusions Relative increased prevalence decidual arteriopathy other features MVM, pattern injury reflecting abnormalities oxygenation within space associated adverse perinatal outcomes. Only was hypertensive despite association MVM disorders preeclampsia. These changes may reflect systemic inflammatory hypercoagulable state influencing physiology.

Language: Английский

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Six-month Follow-up Chest CT Findings after Severe COVID-19 Pneumonia

Radiology, Journal Year: 2021, Volume and Issue: 299(1), P. E177 - E186

Published: Jan. 26, 2021

Background Little is known about the long-term lung radiographic changes in patients who have recovered from coronavirus disease 2019 (COVID-19), especially those with severe disease. Purpose To prospectively assess pulmonary sequelae and explore risk factors for fibrotic-like at 6-month follow-up chest CT of survivors COVID-19 pneumonia. Materials Methods A total 114 (80 [70%] men; mean age, 54 years ± 12) were studied prospectively. Initial scans obtained a 17 days 11 175 20, respectively, after symptom onset. Lung (opacification, consolidation, reticulation, changes) extent scores (score per lobe, 0–5; maximum score, 25) recorded. Participants divided into two groups on basis their scan: evidence (traction bronchiectasis, parenchymal bands, and/or honeycombing) (group 1) without 2). Between-group differences assessed Fisher exact test, two-sample t or Mann-Whitney U test. Multiple logistic regression analyses performed to identify independent predictive changes. Results At CT, was observed 40 participants (35%) 1), whereas remaining 74 (65%) showed either complete radiologic resolution (43 114, 38%) residual ground-glass opacification interstitial thickening (31 27%) Multivariable analysis identified age greater than 50 (odds ratio [OR]: 8.5; 95% CI: 1.9, 38; P = .01), heart rate 100 beats minute admission (OR: 5.6; 1.1, 29; .04), duration hospital stay equal 5.5; 1.5, 21; acute respiratory distress syndrome 13; 3.3, 55; < .001), noninvasive mechanical ventilation 6.3; 1.3, 30; .02), score 18 more 4.2; 1.2, 14; .02) initial as predictors 6 months. Conclusion Six-month one-third survived These associated an older syndrome, longer stays, tachycardia, ventilation, higher score. © RSNA, 2021 Online supplemental material available this article. See also editorial by Wells et al issue.

Language: Английский

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The Emerging Threat of (Micro)Thrombosis in COVID-19 and Its Therapeutic Implications

Circulation Research, Journal Year: 2020, Volume and Issue: 127(4), P. 571 - 587

Published: June 26, 2020

The recent emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the ensuing global pandemic has presented a health emergency unprecedented magnitude. Recent clinical data highlighted that disease 2019 (COVID-19) is associated with significant risk thrombotic complications ranging from microvascular thrombosis, venous thromboembolic disease, stroke. Importantly, are markers COVID-19 multiorgan failure increased mortality. evidence to date supports concept manifestations due ability SARS-CoV-2 invade endothelial cells via ACE-2 (angiotensin-converting enzyme 2), which expressed on cell surface. However, in patients subsequent inflammation, complement activation, thrombin generation, platelet, leukocyte recruitment, initiation innate adaptive immune responses culminate immunothrombosis, ultimately causing (micro)thrombotic complications, such as deep vein pulmonary embolism, Accordingly, activation coagulation (eg, measured plasma D-dimer) thrombocytopenia have emerged prognostic COVID-19. Given central determinants high mortality rate COVID-19, strategies prevent thrombosis critical importance. Several antithrombotic drugs been proposed potential therapies COVID-19-associated including heparin, FXII inhibitors, fibrinolytic drugs, nafamostat, dipyridamole, many also possess pleiotropic anti-inflammatory or antiviral effects. growing awareness mechanistic understanding prothrombotic state driving efforts more stringent diagnostic screening for early institution both prevention therapy complications. shifting paradigm treatment holds promise reduce burden improve prognosis

Language: Английский

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Covid-19 and autoimmunity

Autoimmunity Reviews, Journal Year: 2020, Volume and Issue: 19(8), P. 102597 - 102597

Published: June 11, 2020

Language: Английский

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