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10.1681/ASN.2021010059

http://scihub22266oqcxt.onion/10.1681/ASN.2021010059
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34088853!8722807!34088853
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suck abstract from ncbi


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pmid34088853      J+Am+Soc+Nephrol 2021 ; 32 (10): 2517-2528
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  • High SARS-CoV-2 Viral Load in Urine Sediment Correlates with Acute Kidney Injury and Poor COVID-19 Outcome #MMPMID34088853
  • Caceres PS; Savickas G; Murray SL; Umanath K; Uduman J; Yee J; Liao TD; Bolin S; Levin AM; Khan MN; Sarkar S; Fitzgerald J; Maskey D; Ormsby AH; Sharma Y; Ortiz PA
  • J Am Soc Nephrol 2021[Oct]; 32 (10): 2517-2528 PMID34088853show ga
  • BACKGROUND: AKI is a complication of coronavirus disease 2019 (COVID-19) that is associated with high mortality. Despite documented kidney tropism of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there are no consistent reports of viral detection in urine or correlation with AKI or COVID-19 severity. Here, we hypothesize that quantification of the viral load of SARS-CoV-2 in urine sediment from patients with COVID-19 correlates with occurrence of AKI and mortality. METHODS: The viral load of SARS-CoV-2 in urine sediments (U-viral load) was quantified by qRT-PCR in 52 patients with PCR-confirmed COVID-19 diagnosis, who were hospitalized between March 15 and June 8, 2020. Immunolabeling of SARS-CoV-2 proteins Spike and Nucleocapsid was performed in two COVID-19 kidney biopsy specimens and urine sediments. Viral infectivity assays were performed from 32 urine sediments. RESULTS: A total of 20 patients with COVID-19 (39%) had detectable SARS-CoV-2 U-viral load, of which 17 (85%) developed AKI with an average U-viral load four-times higher than patients with COVID-19 who did not have AKI. U-viral load was highest (7.7-fold) within 2 weeks after AKI diagnosis. A higher U-viral load correlated with mortality but not with albuminuria or AKI stage. SARS-CoV-2 proteins partially colocalized with the viral receptor ACE2 in kidney biopsy specimens in tubules and parietal cells, and in urine sediment cells. Infective SARS-CoV-2 was not detected in urine sediments. CONCLUSION: Our results further support SARS-CoV-2 kidney tropism. A higher SARS-CoV-2 viral load in urine sediments from patients with COVID-19 correlated with increased incidence of AKI and mortality. Urinary viral detection could inform the medical care of patients with COVID-19 and kidney injury to improve prognosis.
  • |*Viral Load[MESH]
  • |Acute Kidney Injury/etiology/urine/*virology[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Angiotensin-Converting Enzyme 2/analysis[MESH]
  • |COVID-19/*complications/urine[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |SARS-CoV-2/*isolation & purification[MESH]
  • |Severity of Illness Index[MESH]


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