![]() ![]() However, with the spread of vaccination, adverse effects of vaccines, including kidney injury, have generated concerns globally ( 6). The infection course, morbidity, and mortality have changed favorably since the advent of vaccines against the new coronavirus in the last year, drastically reducing the number of deaths. Detection of viral fragments in urine by polymerase chain reaction (PCR) was present in 21–50% of infected patients in the second or third week after infection, suggesting the possibility of renal tropism by the virus ( 5). This is probably due to the high expression of proteins, such as ACE2, TMPRSS 2, and cathepsin L that enable viral infection ( 4). Studies from autopsies have shown that the kidneys are a special target organ of the virus, even in patients without a history of kidney disease. The virus incorporation into the cell occurs when proteins present on the surface of the virus, called “spikes,” bind to ACE2 and are endocytosed by activating transmembrane serine protease type 2 (TMPRSS 2), which starts the intracellular viral replication ( 3). These receptors are in large quantities in type II pneumocytes in the lungs, heart, and kidneys. The binding of the viral S protein to the angiotensin-converting enzyme 2 (ACE2) receptor on the surface of host cells triggers SARS-CoV-2 infection. Although the mechanism of injury is not completely understood, it is currently known to go beyond acute tubular necrosis secondary to hemodynamic instability in critically ill patients ( 2). Acute kidney injury (AKI) caused by the new coronavirus is associated with the severe clinical status of patients and, consequently, a worse prognosis ( 2). Since the description of the first report of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, the upper respiratory tract has been well established to be the main infection site however, much evidence has demonstrated that other organs, including the heart, liver, and kidneys in addition to the respiratory tract, can be severely affected ( 1). This study aimed to identify the main renal morphological findings correlated with COVID-19 infection and its vaccination, seeking to understand the pathophysiological mechanisms, main clinical features, and outcomes. Despite the undeniable efficacy of the vaccine, the renal side effects associated with its use deserve to be highlighted, especially the emergence or reactivation of glomerulopathies mentioned in some case reports. The number of deaths has drastically reduced with the advent of large-scale immunization, highlighting the importance of vaccination as the best way to combat the pandemic. However, in addition to lung involvement, kidney injury caused by the novel coronavirus has proven to be a significant factor related to high morbidity and mortality, alarming experts worldwide. ![]() The respiratory tract is the main infection site for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulting in many admissions to intensive care centers in several countries. 5Nephrology and Dialysis Center, Oswaldo Cruz German Hospítal, São Paulo, Brazil.4Division of Nephrology, University of São Paulo, São Paulo, Brazil.3Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.2Division of Nephrology, Hospital das Clínicas of the Federal University of Pernambuco, Recife, Brazil.1Division of Nephrology, University Hospital of the Federal University of Maranhão, São Luís, Brazil.Iago Carvalho Rezende Pacheco 1, Denise Maria do Nascimento Costa 2, Deborah Serra Sousa 1, Natalino Salgado Filho 1, Gyl Eanes Barros Silva 1,3* and Precil Diego Miranda de Menezes Neves 4,5
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |