scholarly journals SARS-CoV-2 infection does not significantly cause acute renal injury: an analysis of 116 hospitalized patients with COVID-19 in a single hospital, Wuhan, China

2020 ◽  
Author(s):  
Luwen Wang ◽  
Xun Li ◽  
Hui Chen ◽  
Shaonan Yan ◽  
Yan Li ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Injury ◽  
Demographic Data ◽  
Pulmonary Inflammation ◽  
Ct Scans ◽  
Test Results ◽  
Acute Renal Injury ◽  
Rt Pcr ◽  
Laboratory Test Results ◽  
Treatment Measures

SummaryBackgroundWhether the patients with COVID-19 infected by SARS-CoV-2 would commonly develop acute renal function damage is a problem worthy of clinical attention. This study aimed to explore the effects of SARS-CoV-2 infection on renal function through analyzing the clinical data of 116 hospitalized COVID-19-confirmed patients.Methods116 hospitalized COVID-19-confirmed patients enrolled in this study were hospitalized in the Department of Infectious Diseases, Renmin Hospital of Wuhan University from January 14 to February 13, 2020. The recorded information includes demographic data, medical history, contact history, potential comorbidities, symptoms, signs, laboratory test results, chest computer tomography (CT) scans, and treatment measures. SARS-CoV-2 RNA in 53 urine sediments of enrolled patients was examined by real-time RT-PCR.Findings12 (10.8%) and 8 (7.2%) patients showed mild elevation of blood urea nitrogen or creatinine, and trace or 1+ albuminuria respectively in 111 COVID-19-confirmed patients without basic kidney disease. In addition, 5 patients with chronic renal failure (CRF) were undergone regular continuous renal replacement therapy (CRRT) were confirmed infection of SARS-CoV-2, and diagnosed as COVID-19. Beside the treatment of COVID-19, CRRT was also applied three times weekly. The course of treatment, the renal function indicators showed stable, without exacerbation of CRF, and pulmonary inflammation was gradually absorbed. All 5 patients with CRF were survived. Moreover, SARS-CoV-2 RNA in urine sediments was positive only in 3 patients from 48 cases without renal illness before, and one patient had a positive for SARS-CoV-2 ORF 1ab from 5 cases with CRF.InterpretationAcute renal impairment was uncommon in COVID-19. SARS-CoV-2 infection does not significantly cause obvious acute renal injury, or aggravate CRF in the COVID-19 patients.

scholarly journals Coronavirus Disease 19 Infection Does Not Result in Acute Kidney Injury: An Analysis of 116 Hospitalized Patients from Wuhan, China

2020 ◽  
Vol 51 (5) ◽  
pp. 343-348 ◽  
Author(s):  
Luwen Wang ◽  
Xun Li ◽  
Hui Chen ◽  
Shaonan Yan ◽  
Dong Li ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Demographic Data ◽  
Pulmonary Inflammation ◽  
Stable State ◽  
Kidney Injury ◽  
Test Results ◽  
Reading Frame ◽  
Laboratory Test Results ◽  
Treatment Measures

Background: Whether the patients with coronavirus disease 19 (COVID-19) infected by severe acute respiratory syndrome (SARS)-CoV-2 would commonly develop acute kidney injury (AKI) is an important issue worthy of clinical attention. This study aimed to explore the effects of SARS-CoV-2 infection on renal function through analyzing the clinical data of 116 hospitalized COVID-19-confirmed patients. Methods: One hundred sixteen COVID-19-confirmed patients enrolled in this study were hospitalized in the Department of Infectious Diseases, Renmin Hospital of Wuhan University from January 14 to February 13, 2020. The recorded information includes demographic data, medical history, contact history, potential comorbidities, symptoms, signs, laboratory test results, chest computer tomography scans, and treatment measures. SARS-CoV-2 RNA in 53 urine sediments of enrolled patients was detected by real-time reverse transcription-polymerase chain reaction. Results: Twelve (10.8%) patients showed mild increase of blood urea nitrogen or creatinine (<26 μmol/L within 48 h), and 8 (7.2%) patients showed trace or 1+ albuminuria in 111 COVID-19-confirmed patients without chronic kidney disease (CKD). All these patients did not meet the diagnostic criteria of AKI. In addition, 5 patients with CKD who were undergone regular continuous renal replacement therapy (CRRT) before admission were confirmed infection of SARS-CoV-2 and diagnosed as COVID-19. In addition to therapy for COVID-19, CRRT was also applied 3 times weekly during hospitalization for these 5 patients with CKD. In the course of treatment, the renal function indicators showed stable state in all 5 patients with CKD, without exacerbation of CKD, and pulmonary inflammation was gradually absorbed. All 5 patients with CKD were survived. Moreover, SARS-CoV-2 RNA in urine sediments was positive only in 3 patients from 48 cases without CKD, and 1 patient had a positive for SARS-CoV-2 open reading frame 1ab from 5 cases with CKD. Conclusion: AKI was uncommon in COVID-19. SARS-CoV-2 infection does not result in AKI, or aggravate CKD in the COVID-19 patients.

scholarly journals COVID-19 and pregnancy – where are we now? A review

2020 ◽  
Vol 48 (5) ◽  
pp. 428-434 ◽  
Author(s):  
Aleksandra Rajewska ◽  
Wioletta Mikołajek-Bedner ◽  
Joanna Lebdowicz-Knul ◽  
Małgorzata Sokołowska ◽  
Sebastian Kwiatkowski ◽  
...  
Keyword(s):  
Case Fatality ◽  
Fetal Distress ◽  
Delivery Mode ◽  
Test Results ◽  
Rt Pcr ◽  
Third Trimester ◽  
The Third ◽  
Laboratory Test Results ◽  
Protective Antibodies ◽  
Polymerase Chain

AbstractThe new acute respiratory disease severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is highly contagious. It has caused many deaths, despite a relatively low general case fatality rate (CFR). The most common early manifestations of infection are fever, cough, fatigue and myalgia. The diagnosis is based on the exposure history, clinical manifestation, laboratory test results, chest computed tomography (CT) findings and a positive reverse transcription-polymerase chain reaction (RT-PCR) result for coronavirus disease 2019 (COVID-19). The effect of SARS-CoV-2 on pregnancy is not already clear. There is no evidence that pregnant women are more susceptible than the general population. In the third trimester, COVID-19 can cause premature rupture of membranes, premature labour and fetal distress. There are no data on complications of SARS-CoV-2 infection before the third trimester. COVID-19 infection is an indication for delivery if necessary to improve maternal oxygenation. Decision on delivery mode should be individualised. Vertical transmission of coronavirus from the pregnant woman to the fetus has not been proven. As the virus is absent in breast milk, the experts encourage breastfeeding for neonatal acquisition of protective antibodies.

Renal Impairment in Patients With Multiple Myeloma: A Consensus Statement on Behalf of the International Myeloma Working Group

2010 ◽  
Vol 28 (33) ◽  
pp. 4976-4984 ◽  
Author(s):  
Meletios A. Dimopoulos ◽  
Evangelos Terpos ◽  
Asher Chanan-Khan ◽  
Nelson Leung ◽  
Heinz Ludwig ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Renal Function ◽  
Renal Impairment ◽  
Light Chain ◽  
Renal Injury ◽  
High Dose ◽  
Acute Renal Injury ◽  
High Dose Dexamethasone ◽  
Cast Nephropathy ◽  
High Dose Melphalan

Renal impairment is a common complication of multiple myeloma (MM). The estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease formula is the recommended method for the assessment of renal function in patients with MM with stabilized serum creatinine. In acute renal injury, the RIFLE (risk, injury, failure, loss and end-stage kidney disease) and Acute Renal Injury Network criteria seem to be appropriate to define the severity of renal impairment. Novel criteria based on eGFR measurements are recommended for the definition of the reversibility of renal impairment. Rapid intervention to reverse renal dysfunction is critical for the management of these patients, especially for those with light chain cast nephropathy. Bortezomib with high-dose dexamethasone is considered as the treatment of choice for such patients. There is limited experience with thalidomide in patients with myeloma with renal impairment. Thus, thalidomide can be carefully administered, mainly in the context of well-designed clinical trials, to evaluate if it can improve the rapidity and probability of response that is produced by the combination with bortezomib and high-dose dexamethasone. Lenalidomide is effective in this setting and can reverse renal insufficiency in a significant subset of patients, when it is given at reduced doses, according to renal function. The role of plasma exchange in patients with suspected light chain cast nephropathy and renal impairment is controversial. High-dose melphalan (140 mg/m2) and autologous stem-cell transplantation should be limited to younger patients with chemosensitive disease.

Renal Insufficiency and Failure

Hematology ◽  
2010 ◽  
Vol 2010 (1) ◽  
pp. 431-436 ◽  
Author(s):  
Meletios A. Dimopoulos ◽  
Evangelos Terpos
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Renal Impairment ◽  
Renal Disease ◽  
Renal Injury ◽  
Filtration Rate ◽  
Acute Renal Injury ◽  
Sustained Improvement ◽  
Definition Of

Abstract Renal impairment is a common complication of multiple myeloma. Chronic renal failure is classified according to glomerular filtration rate as estimated by the MDRD (modification of diet in renal disease) formula, while RIFLE (risk, injury, failure, loss and end-stage renal disease) and AKIN (acute renal injury network) criteria may be used for the definition of the severity of acute renal injury. Novel criteria based on estimated glomerular filtration rate measurements are proposed for the definition of the reversibility of renal impairment. Renal complete response (CRrenal) is defined as sustained (i.e., lasting at least 2 months) improvement of creatinine clearance (CRCL) from under 50 mL/min at baseline to 60 mL/min or above. Renal partial response (PRrenal) is defined as sustained improvement of CRCL from under 15 mL/min at baseline to 30 to 59 mL/min. Renal minor response (MRrenal) is defined as sustained improvement of the baseline CRCL of under 15 mL/min to 15 to 29 mL/min or, if baseline CRCL was 15 to 29 mL/min, improvement to 30 to 59 mL/min. Bortezomib with high-dose dexamethasone is considered the treatment of choice for myeloma patients with renal impairment and improves renal function in most patients. Although there is limited experience with thalidomide, this agent can be administered at the standard dosage to patients with renal failure. Lenalidomide, when administered at reduced doses according to renal function, is effective and can reverse renal impairment in a subset of myeloma patients.

scholarly journals Diagnostic value of chest CT in outpatient for COVID-19 compare with RT-PCR

2020 ◽  
Author(s):  
Weiwei Zhang ◽  
Meifen Zhu ◽  
Min Zhang
Keyword(s):  
Laboratory Test ◽  
Ground Glass Opacity ◽  
Diagnostic Value ◽  
Chest Ct ◽  
Test Results ◽  
Imaging Data ◽  
Rt Pcr ◽  
Spider Web ◽  
Lesion Location ◽  
Laboratory Test Results

Abstract ObjectivesThe pneumonia caused by the 2019 novel coronavirus recently break out in Wuhan, China, and was named as COVID-19. With the spread of the disease, it bring numbers of casualties,so now we need a way could fast and accuracy diagnose the disease.This paper aims to compare two way for diagnose COVID-19 in outpatient :Chest CT and RT-PCR.Materials and methodsThe study picked 248 patients who treated in fever clinical of GanZhou people's hospital,their complete clinical and imaging data were analysed retrospectively.Epidemiological data,symoptoms,laboratory test results include RT-PCR and the CT results include CT features,lesion location,lesion distribution of suspected COVID-19 infected patients were gathered.ResultsAll of 248 patients,at last 20 patients confirmed COVID-19,15 patients were confirmed in outpatient.More than 200 cases has laboratory test results disnormal.Only 15/248 patients had initial positive RT-PCR for COVID-19,5 patients had COVID-19 confirmed by two or more RT-PCR.50 cases(20.2%) had Ground glass opacity,42 cases(16.9%) had Consolidation,39 cases(15.7%) had Spider web pattern,38 cases(15.3%) had Interlobular septal thickening.For lesion location,22 cases(8.9%) involved Single lobe of one lung,13 cases(5.2%) involved Multiple lobes of one lung,174 cases(70.2%) involved Multiple lobes of both lungs,9 cases(3.6%) involved Bilateral lower lungs,25 cases(10.1%) involved Bilateral middle and lower lungs.Regarding the distribution of the lesions in the lung lobes,119 cases(47.98%) involved Subpleural distribution,19 cases(7.7%) involved Diffuse distribution,7 cases(2.8%) involved Peribronchial distribution,81 cases(32.7%) involved Mixed distribution.ConclusionChest CT can be applied in outpatient to make early diagnosis with sensitivity and accuracy better than that of nucleic acid detection.Trial registrationChiCTR2000032574. Registered 3 May 2020. retrospectively registered

scholarly journals Urinary fibrinogen is elevated in hospitalized patients undergoing angiography

Vascular ◽  
2018 ◽  
Vol 27 (1) ◽  
pp. 33-37
Author(s):  
Tian Du ◽  
Honglin Dong ◽  
Chunhong Li ◽  
Sheng Yan ◽  
Haifeng Li
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Renal Injury ◽  
Spearman Correlation ◽  
Acute Renal Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Baseline Levels ◽  
The Relationship ◽  
Wallis Anova

Objectives Previously, we found that urinary fibrinogen (Fg) levels were positively related to contrast-induced acute renal injury degree in mice. Reduction of fibrinogen in heterozygous mice can improve renal function. Here, we prospectively observed the variation in urinary Fg levels in patients undergoing angiography to determine the relationship between serum creatinine (Scr) and serum cystatin C (Cys C) levels. Methods Serum Cys C and urinary Fg levels were evaluated by ELISA before and 2, 12, and 24 h after angiography in 115 enrolled inpatients. Scr was assessed before and 24 and 48 h after angiography. Data were analyzed using ANOVA or Kruskal–Wallis ANOVA and Spearman correlation. Results Urinary Fg levels were elevated as early as 2 h after angiography and decreased thereafter before returning to baseline levels 24 h after angiography. Urinary Fg was correlated with the amount of contrast agent ( r = 0.24, p = 0.036) and the presence of diabetes and hypertension ( r = 0.31, r = 0.28, p < 0.05, respectively). Urinary Fg levels 2 h after angiography were positively related with Cys C at 12 and 24 h and Scr at 48 h after angiography ( r = 0.34, r = 0.51, r = 0.85, p < 0.05, respectively). Conclusions Our results showed that variations in urinary Fg levels are consistent with serum Cys C and Scr in patients undergoing angiography and that urinary Fg levels were the earliest parameter to become elevated. Urinary Fg should be investigated as a useful predictor for abnormal renal function after angiography.

scholarly journals A Case of Upper Ureter Rupture With Acute Kidney Injury

2018 ◽  
Vol 11 ◽  
pp. 117954761878513
Author(s):  
Yuko Mutsuyoshi ◽  
Shohei Kaneko ◽  
Saori Minato ◽  
Katsunori Yanai ◽  
Hiroki Ishii ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Injury ◽  
Urine Output ◽  
Urinary Catheter ◽  
Kidney Injury ◽  
Benign Prostatic Hypertrophy ◽  
Acute Renal Injury ◽  
Surgical Operation ◽  
Normal Range

We herein report a case of ureter rupture with severe oliguric acute renal injury due to benign prostatic hypertrophy. After insertion of an indwelling urinary catheter, the patient’s urine output immediately increased. His symptoms and renal function also rapidly improved to the normal range without a surgical operation. Clinicians should note this complication in patients with oliguria.

The “Hyperacute” Extraaxial Intracranial Hematoma: Computed Tomographic Findings and Clinical Significance

Neurosurgery ◽  
1985 ◽  
Vol 17 (1) ◽  
pp. 48-56 ◽  
Author(s):  
Jonathan Greenberg ◽  
Wendy A. Cohen ◽  
Paul R. Cooper
Keyword(s):  
Laboratory Test ◽  
Clinical Significance ◽  
Disseminated Intravascular Coagulation ◽  
Clinical Picture ◽  
Surgical Decompression ◽  
Ct Scans ◽  
Test Results ◽  
Intracranial Hematoma ◽  
Computed Tomographic ◽  
Laboratory Test Results

Abstract Thirteen patients with acute subdural and epidural hematomas were found to have fresh, unclotted blood at the time of surgical decompression several hours after injury. Computed tomographic (CT) scans of these patients demonstrated areas of hyperdensity, corresponding to clotted hematoma, admixed with areas of isodensity, corresponding to liquid blood. Active bleeding from identifiable loci was found in 11 patients, 4 of whom had massive hemorrhages. Clotting abnormalities ranging from slightly elevated laboratory test results to a full-blown clinical picture of disseminated intravascular coagulation occurred in 8 patients. We describe the CT pictures of these “hyperacute” lesions, and we postulate that such CT presentations indicate either the presence of ongoing active intracranial bleeding or the onset of a coagulopathy complicating the management of these lesions.

scholarly journals Machine Learning Highlights Downtrending of COVID-19 Patients with a Distinct Laboratory Profile

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
He S. Yang ◽  
Yu Hou ◽  
Hao Zhang ◽  
Amy Chadburn ◽  
Lars F. Westblade ◽  
...  
Keyword(s):  
Machine Learning ◽  
New York ◽  
High Risk ◽  
Laboratory Test ◽  
Laboratory Test Result ◽  
Test Results ◽  
Rt Pcr ◽  
Laboratory Test Results ◽  
Laboratory Profile ◽  
Test Result

Background. New York City (NYC) experienced an initial surge and gradual decline in the number of SARS-CoV-2-confirmed cases in 2020. A change in the pattern of laboratory test results in COVID-19 patients over this time has not been reported or correlated with patient outcome. Methods. We performed a retrospective study of routine laboratory and SARS-CoV-2 RT-PCR test results from 5,785 patients evaluated in a NYC hospital emergency department from March to June employing machine learning analysis. Results. A COVID-19 high-risk laboratory test result profile (COVID19-HRP), consisting of 21 routine blood tests, was identified to characterize the SARS-CoV-2 patients. Approximately half of the SARS-CoV-2 positive patients had the distinct COVID19-HRP that separated them from SARS-CoV-2 negative patients. SARS-CoV-2 patients with the COVID19-HRP had higher SARS-CoV-2 viral loads, determined by cycle threshold values from the RT-PCR, and poorer clinical outcome compared to other positive patients without the COVID12-HRP. Furthermore, the percentage of SARS-CoV-2 patients with the COVID19-HRP has significantly decreased from March/April to May/June. Notably, viral load in the SARS-CoV-2 patients declined, and their laboratory profile became less distinguishable from SARS-CoV-2 negative patients in the later phase. Conclusions. Our longitudinal analysis illustrates the temporal change of laboratory test result profile in SARS-CoV-2 patients and the COVID-19 evolvement in a US epicenter. This analysis could become an important tool in COVID-19 population disease severity tracking and prediction. In addition, this analysis may play an important role in prioritizing high-risk patients, assisting in patient triaging and optimizing the usage of resources.

scholarly journals The Association between Poor Glycemic Control in Diabetes Mellitus and Progression of COVID-19

2020 ◽  
Author(s):  
AliReza Estedlal ◽  
Marjan Jeddi ◽  
Seyed Taghi Heydari ◽  
Mohammad Hossein Dabbaghmanesh
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Glycemic Control ◽  
Laboratory Test ◽  
Demographic Data ◽  
Elevated Serum ◽  
Diabetic Patients ◽  
Test Results ◽  
South Central ◽  
Laboratory Test Results

Abstract Background: Coronavirus disease 2019 (COVID-19) is a newly recognized disease whose rapid spread has resulted in a global pandemic. In this resepct, there are several comorbidities presumed to be associated with presentation of complications in COVID-19 such as diabetes mellitus (DM), hypertension (HTN), and cardiovascular diseases (CVDs). Therefore, this study aimed to explore whether DM was a risk factor influencing presentation, progression, and prognosis of COVID-19 or not.Methods: A total number of 447 patients with confirmed COVID-19 were selected from two centers for COVID-19 in the city of Shiraz, south-central Iran, from February 20 to April 29, 2020. Then, demographic data, medical history, signs and symptoms, laboratory test results, as well as chest computed tomography (CT) scan reports were collected and analyzed.Results: This study revealed that older age, HTN, and CVDs could be mostly seen in diabetic patients with COVID-19. In addition, such patients had prolonged hospital stay, lower oxygen (O2) saturation, and abnormal laboratory test results such as higher white blood cell (WBC) count, lower lymphocyte count, elevated serum tumor markers such as aspartate aminotransferase (AST), and abnormal kidney function.Conclusion: DM is an important risk factor for adverse endpoints in patients with COVID-19. In diabetic patients, proper consideration of clinical characteristics is thus of utmost importance. In addition, special clinical insight for disease prevention, good glycemic control during hospitalization, and efforts to develop a vaccine can help improve disease outcomes in this population.

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