Urinary Levels of SARS-CoV-2 Nucleocapsid Protein Associate With Risk of AKI and COVID-19 Severity: A Single-Center Observational Study.

Autor:	Tampe D; Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany., Hakroush S; Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany., Bösherz MS; Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany., Franz J; Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany.; Max Planck Institute for Experimental Medicine, Göttingen, Germany.; Campus Institute for Dynamics of Biological Networks, University of Göttingen, Göttingen, Germany., Hofmann-Winkler H; Infection Biology Unit, German Primate Center, Leibniz Institute for Primate Research Göttingen, Göttingen, Germany., Pöhlmann S; Infection Biology Unit, German Primate Center, Leibniz Institute for Primate Research Göttingen, Göttingen, Germany.; Faculty of Biology and Psychology, University Göttingen, Göttingen, Germany., Kluge S; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Moerer O; Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center Göttingen, Göttingen, Germany., Stadelmann C; Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany., Ströbel P; Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany., Winkler MS; Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center Göttingen, Göttingen, Germany., Tampe B; Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2021 May 25; Vol. 8, pp. 644715. Date of Electronic Publication: 2021 May 25 (Print Publication: 2021).
DOI:	10.3389/fmed.2021.644715
Abstrakt:	Background: Acute kidney injury (AKI) is very common in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease 2019 (COVID-19) and considered as a risk factor for COVID-19 severity. SARS-CoV-2 renal tropism has been observed in COVID-19 patients, suggesting that direct viral injury of the kidneys may contribute to AKI. We examined 20 adult cases with confirmed SARS-CoV-2 infection requiring ICU supportive care in a single-center prospective observational study and investigated whether urinary markers for viral infection (SARS-CoV-2 N) and shedded cellular membrane proteins (ACE2, TMPRSS2) allow identification of patients at risk for AKI and outcome of COVID-19. Objectives: The objective of the study was to evaluate whether urinary markers for viral infection (SARS-CoV-2 N) and shedded cellular membrane proteins (ACE2, TMPRSS2) allow identification of patients at risk for AKI and outcome of COVID-19. Results: Urinary SARS-CoV-2 N measured at ICU admission identified patients at risk for AKI in COVID-19 (HR 5.9, 95% CI 1.4-26, p = 0.0095 ). In addition, the combination of urinary SARS-CoV-2 N and plasma albumin measurements further improved the association with AKI (HR 11.4, 95% CI 2.7-48, p = 0.0016 ). Finally, combining urinary SARS-CoV-2 N and plasma albumin measurements associated with the length of ICU supportive care (HR 3.3, 95% CI 1.1-9.9, p = 0.0273 ) and premature death (HR 7.6, 95% CI 1.3-44, p = 0.0240 ). In contrast, urinary ACE2 and TMPRSS2 did not correlate with AKI in COVID-19. Conclusions: In conclusion, urinary SARS-CoV-2 N levels associate with risk for AKI and correlate with COVID-19 severity. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Tampe, Hakroush, Bösherz, Franz, Hofmann-Winkler, Pöhlmann, Kluge, Moerer, Stadelmann, Ströbel, Winkler and Tampe.)
Databáze:	MEDLINE
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