Coronavirus Disease 2019: Coronaviruses and Kidney Injury.

Lv, Wenchang; Wu, Min; Ren, Yuping; Zeng, Ning; Deng, Pei; Zeng, Hong; Zhang, Qi; Wu, Yiping

PURPOSE The first case of coronavirus disease 2019 (COVID-19) was identified and confirmed in December 2019 in Wuhan, China. COVID-19 is gradually posing a serious threat to global public health. In this review, the characteristics and mechanism of kidney injury caused by SARS-CoV, MERS-CoV, and SARS-CoV-2 infection are summarized and contrasted. Especially, urine-oral transmission, prevention and management of the kidney injury caused by SARS-CoV-2 were emphasized. MATERIALS AND METHODS We searched PubMed for English language articles published since 2003 with the keywords "SARS", "MERS", "COVID-19" or "kidney injury". ClinicalTrials.gov was queried for ongoing studies. We also used relevant data from websites, including Centers for Disease Control and Prevention (CDC) and European Centre for Disease Prevention and Control (ECDC). RESULTS Similar to two other coronaviruses including SARS-CoV and MERS-CoV, SARS-CoV-2 caused severe respiratory syndrome with rapid progression and kidney injury. The infection process of SARS-CoV-2 is mediated by specifically binding to ACE2. The COVID-19 patients combined with kidney impairment are associated with a higher risk of mortality, compared with those without comorbidities. The pathological changes of the kidney are mainly due to local SARS-CoV-2 replication or indirectly by pro-inflammatory cytokine response. Besides, studies have confirmed the isolation of infectious SARS-CoV-2 in urine, raising the possibility of urine-oral transmission. Thus, it is significant for preventing possible potential urine-oral transmission and improving the cure rate of acute kidney injury of COVID-19. CONCLUSIONS Emerging evidence supports that in patients with SARS-CoV-2 infections, the prevalence of kidney injury is high and usually leads to a poor prognosis. The optimal prevention, management of kidney injury will benefit for COVID-19 patients.