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      Mecanismos patogénicos de infección por SARS-CoV-2 y enfermedad renal: una perspectiva clínico-molecular Translated title: Pathogenic mechanisms of SARS-CoV-2 infection and kidney disease: a clinical and molecular perspective

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          Abstract

          Resumen La infección por SARS-CoV-2 se ha convertido en un problema mundial de salud pública. Su presentación clínica es variada, desde benigna hasta un síndrome de distrés respiratorio agudo, afectación sistémica y fallo multiorgánico. La severidad del cuadro clínico depende de factores biológicos del virus y del huésped y de comorbilidades como la enfermedad renal. Además, la interacción entre el virus, la enzima convertidora de angiotensina 2 y la respuesta inmunológica exacerbada podría conducir al desarrollo de lesión renal aguda. Sin embargo, las implicaciones de la infección por SARS-CoV-2 sobre las células renales, las repercusiones pronósticas en los pacientes con enfermedad renal crónica y su efecto a largo plazo sobre la función renal no están del todo claras. El objetivo es revisar el papel del SARS-CoV-2 en la enfermedad renal aguda y crónica, y sus posibles mecanismos patogénicos en la afectación renal.

          Translated abstract

          Abstract The SARS-CoV-2 infection has become as a worldwide public health emergency. It exhibits a variety of clinical presentations, ranging from benign to acute respiratory distress syndrome, systemic involvement, and multiorganic failure. The severity of the clinical picture depends on host and virus biological features and the presence of comorbidities such as chronic kidney disease. In addition, the interaction between the virus, angiotensin-converting enzyme 2, and the exacerbated immune response could lead to the development of acute kidney injury. However, the implications of SARS-CoV-2 infection on renal cells, the prognosis of patients with chronic kidney disease, and the long-term behavior of renal function are not entirely understood. This review aims to explore the role of SARS-CoV-2 in acute and chronic kidney disease and the possible pathogenic mechanisms of renal involvement.

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Chaolin Huang, Yeming Wang, Xingwang Li … (2020)
          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Clinical Characteristics of Coronavirus Disease 2019 in China

            Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)
            Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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              Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

              Dawei Wang, Bo Hu, Fangfang Zhu … (2020)
              In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
              Article 0 comments Cited 11077 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (publisher-id): asisna
                Title: Anales del Sistema Sanitario de Navarra
                Abbreviated Title: Anales Sis San Navarra
                Publisher: Gobierno de Navarra. Departamento de Salud (Pamplona, Navarra, Spain )
                ISSN (Print): 1137-6627
                Publication date (Print and electronic): December 2021
                Volume: 44
                Issue: 3
                Pages: 445-456
                Affiliations
                [3] Cúcuta Atlántico orgnameUniversidad Simón Bolívar orgdiv1Facultad de Ciencias Sociales y Jurídicas Colombia
                [4] Alcalá de Henares Madrid orgnameHospital Universitario Príncipe de Asturias orgdiv1Sección de Nefrología España
                [5] Barranquilla Atlántico orgnameUniversidad Simón Bolívar orgdiv1Facultad de Ciencias de la Salud Colombia
                [2] Valencia Valencia orgnameUniversitat de Valencia orgdiv1Departamento de Nefrología. INCLIVA orgdiv2Hospital Clínico Universitario Spain
                [1] Maracaibo orgnameUniversidad del Zulia orgdiv1Escuela de Medicina orgdiv2Centro de Investigaciones Endocrino-Metabólicas "Dr. Félix Gómez" Venezuela
                Article
                Publisher ID: S1137-66272021000300445 Publisher ID: S1137-6627(21)04400300445
                DOI: 10.23938/assn.0973
                SO-VID: 042dc624-1181-4679-aeaa-75f495db897f
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                Date accepted : 26 March 2021
                Date received : 26 October 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 70, Pages: 12
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                SciELO Spain

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                Subject: Revisiones

                Keywords: Acute kidney injury,SARS-CoV-2,COVID-19,Angiotensin-converting enzyme 2,Chronic kidney disease,Enzima convertidora de angiotensina 2,Enfermedad renal crónica,Lesión renal aguda
                Data availability:
                Keywords: Acute kidney injury, SARS-CoV-2, COVID-19, Angiotensin-converting enzyme 2, Chronic kidney disease, Enzima convertidora de angiotensina 2, Enfermedad renal crónica, Lesión renal aguda

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