key: cord-0764855-4ge3dtxl
authors: de Souza, S. P.; Silveira, M. A. D.; Souza, B. S. d. F.; Nonaka, C. K. V.; de Melo, E.; Cabral, J. B.; Coelho, F.; Passos, R. d. H.
title: Evaluation of Urine SARS-COV-2 RT-PCR as a predictor of Acute Kidney Injury and disease severity in critical COVID-19 patients
date: 2021-01-15
journal: nan
DOI: 10.1101/2021.01.13.21249576
sha: f89d03f2d983fb580e01739190d1f0d7cd762317
doc_id: 764855
cord_uid: 4ge3dtxl

The novel coronavirus disease (COVID-19) is an emerging infectious disease caused by SARS-CoV-2, which began as an outbreak in Wuhan, China and spread rapidly throughout the globe. Although the majority of infections are mild, severe and critical COVID-19 patients face deterioration of respiratory function, and may also present extrapulmonary manifestations, mostly affecting the kidney, digestive tract, heart and nervous system. Here, we prospectively evaluated the presence of SARS-CoV-2 genetic material by RT-PCR in urine samples obtained from critical care COVID-19 patients. In 51 patients included, we found higher serum creatinine levels, a longer hospital stay and a more frequent dialysis need in urine-positive patients. These findings could suggest that, in predisposed patients, a direct viral cytopathic effect may contribute to a more severe disease phenotype

Also, renal abnormalities as hematuria and proteinuria are commonly reported, and associated with higher mortality 8 . However, the clinical relevance of the coronavirusinduced cytopathic effect in the AKI of COVID-19 remains unclear.

Here, we prospectively evaluated the presence of SARS-CoV-2 genetic material by RT-PCR in urine samples obtained from COVID-19 patients admitted in the intensive care units in Hospital São Rafael in Salvador, Brazil. We intended to investigate a possible association between positive results of SARS-CoV-2 RT-PCR in urine samples and AKI onset, and abnormalities in urine sediments. Our hypothesis was that the virus would be detected more frequently in patients that develop AKI, supporting the role for a direct cytopathic effect in the renal parenchymal as the underlying mechanism of AKI in COVID-19 patients.

The study was conducted following the principles of the Declaration of Helsinki and received prior approval by the Ethics Committee of São Rafael Hospital in Salvador, Brazil (CAAE 34428920.0.0000.0048). All participants gave informed consent.

All adult patients with suspected COVID-19 pneumonia requiring oxygen supplementation admitted to the intensive care unit of São Rafael Hospital between July 10th and September 16th 2020 were screened for eligibility. Patients were included in the study if they received the diagnosis of COVID-19 pneumonia confirmed by nasopharyngeal RT-PCR and chest CT scan. Fifty-one subjects were included in the . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) 

Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China

Prevalence and impact of acute renal impairment on COVID-19: a systematic review and meta-analysis

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Kidney disease is associated with inhospital death of patients with COVID-19

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

The Novel Coronavirus 2019 epidemic and kidneys

Renal histopathological analysis of 26 postmortem findings of patients with COVID19 in China

Renal Involvement and early prognosis in patients with COVID -19 pneumonia

Presence of SARS-Cov-2 in urine is rare and not associated with acute kidney injury in critically ill COVID-19 patients