Caution on Kidney Dysfunctions of 2019-nCoV Patients

Abstract

Until 24:00 of February 7th 2020, 31774 laboratory-confirmed cases of novel coronavirus (2019-nCoV) infection have been reported, including 6101 severe cases in critical conditions and 722 deaths. The critical and urgent need at this moment is to find an effective treatment strategy with available means to prevent these thousands of severe inpatients from worsening and dying. It has been recently known that the 2019-nCoV shares a common cellular mechanism with the severe acute respiratory syndrome-associated coronavirus (SARS-CoV). Thus, we surveyed a previous retrospective case study on SARS which showed that acute renal impairment was uncommon in SARS but carried a formidably high mortality (91.7%, 33 of 36 cases). Here we report an ongoing case study on kidney functions in 59 patients infected by 2019-nCoV (including 28 diagnosed as severe cases and 3 deaths). 63% (32/51) of the patients exhibited proteinuria, indicative of renal impairment. 19% (11/59) and 27% (16/59) of the patients had an elevated level of plasma creatinine and urea nitrogen respectively. The computerized tomography (CT) scan showed radiographic abnormalities of the kidneys in 100% (27/27) of the patients. Together, these multiple lines of evidence point to the idea that renal impairment is common in 2019-nCov patients, which may be one of the major causes of the illness by the virus infection and also may contribute to multi-organ failure and death eventually. Therefore, we strongly suggest exercising a high degree of caution in monitoring the kidney functions of 2019-nCoV patients and, very importantly, that applying potential interventions including continuous renal replacement therapies (CRRT) for protecting kidney functions as early as possible, particular for those with plasma creatinine rising, is key to preventing fatality.