tetano
Editor, Senior Moderator
Diagnostics (Basel)
. 2021 Nov 12;11(11):2089.
doi: 10.3390/diagnostics11112089.
Urinary SARS-CoV-2 RNA Is an Indicator for the Progression and Prognosis of COVID-19
Lu Zhang[SUP] 1 [/SUP], Maoqing Tian[SUP] 1 [/SUP], Yuan Song[SUP] 1 [/SUP], Wei Liang[SUP] 1 [/SUP], Xiaogang Li[SUP] 2 [/SUP], Yongqing Tong[SUP] 3 [/SUP], Huiming Wang[SUP] 1 [/SUP]
Affiliations
Abstract
Background: We aimed to analyze clinical characteristics and find potential factors to predict poor prognosis in patients with coronavirus disease 2019 (COVID-19).
Methods: We analyzed the clinical characteristics and laboratory tests of COVID-19 patients and detected SARS-CoV-2 RNA in urine sediments collected from 53 COVID-19 patients enrolled in Renmin Hospital of Wuhan University from 31 January 2020 to 18 February 2020 with qRT-PCR analysis. Then, we classified those patients based on clinical conditions (severe or non-severe syndrome) and urinary SARS-CoV-2 RNA (U[SUB]RNA[/SUB][SUP]-[/SUP] or U[SUB]RNA[/SUB][SUP]+[/SUP]).
Results: We found that COVID-19 patients with severe syndrome (severe patients) showed significantly higher positive rate (11 of 23, 47.8%) of urinary SARS-CoV-2 RNA than non-severe patients (4 of 30, 13.3%, p = 0.006). U[SUB]RNA[/SUB][SUP]+[/SUP] patients or severe U[SUB]RNA[/SUB][SUP]+[/SUP] subgroup exhibited higher prevalence of inflammation and immune discord, cardiovascular diseases, liver damage and renal dysfunction, and higher risk of death than U[SUB]RNA[/SUB][SUP]-[/SUP] patients. To understand the potential mechanisms underlying the viral urine shedding, we performed renal histopathological analysis on postmortems of patients with COVID-19 and found severe renal vascular endothelium lesion characterized by an increase of the expression of thrombomodulin and von Willebrand factor, markers to assess the endothelium dysfunction. We proposed a theoretical and mathematic model to depict the potential factors that determine the urine shedding of SARS-CoV-2.
Conclusions: This study indicated that urinary SARS-CoV-2 RNA detected in urine specimens can be used to predict the progression and prognosis of COVID-19 severity.
Keywords: COVID-19; SARS-CoV-2; endothelium; indicator; renal pathology.
. 2021 Nov 12;11(11):2089.
doi: 10.3390/diagnostics11112089.
Urinary SARS-CoV-2 RNA Is an Indicator for the Progression and Prognosis of COVID-19
Lu Zhang[SUP] 1 [/SUP], Maoqing Tian[SUP] 1 [/SUP], Yuan Song[SUP] 1 [/SUP], Wei Liang[SUP] 1 [/SUP], Xiaogang Li[SUP] 2 [/SUP], Yongqing Tong[SUP] 3 [/SUP], Huiming Wang[SUP] 1 [/SUP]
Affiliations
- PMID: 34829436
- DOI: 10.3390/diagnostics11112089
Abstract
Background: We aimed to analyze clinical characteristics and find potential factors to predict poor prognosis in patients with coronavirus disease 2019 (COVID-19).
Methods: We analyzed the clinical characteristics and laboratory tests of COVID-19 patients and detected SARS-CoV-2 RNA in urine sediments collected from 53 COVID-19 patients enrolled in Renmin Hospital of Wuhan University from 31 January 2020 to 18 February 2020 with qRT-PCR analysis. Then, we classified those patients based on clinical conditions (severe or non-severe syndrome) and urinary SARS-CoV-2 RNA (U[SUB]RNA[/SUB][SUP]-[/SUP] or U[SUB]RNA[/SUB][SUP]+[/SUP]).
Results: We found that COVID-19 patients with severe syndrome (severe patients) showed significantly higher positive rate (11 of 23, 47.8%) of urinary SARS-CoV-2 RNA than non-severe patients (4 of 30, 13.3%, p = 0.006). U[SUB]RNA[/SUB][SUP]+[/SUP] patients or severe U[SUB]RNA[/SUB][SUP]+[/SUP] subgroup exhibited higher prevalence of inflammation and immune discord, cardiovascular diseases, liver damage and renal dysfunction, and higher risk of death than U[SUB]RNA[/SUB][SUP]-[/SUP] patients. To understand the potential mechanisms underlying the viral urine shedding, we performed renal histopathological analysis on postmortems of patients with COVID-19 and found severe renal vascular endothelium lesion characterized by an increase of the expression of thrombomodulin and von Willebrand factor, markers to assess the endothelium dysfunction. We proposed a theoretical and mathematic model to depict the potential factors that determine the urine shedding of SARS-CoV-2.
Conclusions: This study indicated that urinary SARS-CoV-2 RNA detected in urine specimens can be used to predict the progression and prognosis of COVID-19 severity.
Keywords: COVID-19; SARS-CoV-2; endothelium; indicator; renal pathology.