Varyant B.1.1.7 Pozitif ve Negatif SARS-CoV-2 Enfeksiyonunda Akut Böbrek Yetmezliği ve Mortalitenin Karşılaştırılması

Öz

Amaç:. Bu çalışmada varyant B.1.1.7 pozitif ve negatif SARS-CoV-2 enfeksiyonu olan hastalarda akut böbrek hasarı gelişimi ve mortalite oranlarının karşılaştırılması amaçlanmıştır. Materyal ve Metod: Çalışmaya varyant B.1.1.7 negatif 92 (grup I) ve 57 varyant B.1.1.7 pozitif 57 (grup II) SARS-CoV-2 hastası dahil edildi. Her hastanın demografik verileri, komorbiditeleri, yoğun bakım yatış gün sayıları, invaziv mekanik ventilatör ihtiyacı, mekanik ventilatör gün sayısı, akut böbrek yetmezliği gelişip gelişmediği, gelişti ise kaçıncı günde akut böbrek yetmezliği geliştiği ve tedavinin sonlanım şekilleri kaydedildi. Bulgular: Grup II hastalara 17/57 (29.8%) grup I hastalara 31/92 (33.7%) göre daha fazla oranda akut böbrek hasarı gelişti (p=0.04). Grup I’de 46/92 (50 %) grup II’de 38/57 (66.7%) hasta hasta invaziv mekanik ventilasyon desteğine alındı (p <0.05). Akut böbrek hasarı gelişmeyen hastaların mortalite oranı grup II’de 22/40 (55%) grup I’e 19/61 (31.2%) göre daha yüksekti (p<0.05). Sonuç: Varyant B.1.1.7 enfeksiyonu olan hastalarda akut böbrek hasarı gelişiminin diğer grup hastalara göre daha az olduğu saptanmıştır. Varyant B.1.1.7 enfeksiyonundaki mortalite artışının akut böbrek hasarı gelişiminden bağımsız olarak gerçekleştiğini düşündürmektedir.

Anahtar Kelimeler

• COVID-19
• varyant B.1.1.7
• akut böbrek hasarı
• mortalite

Comparison of Acute Kidney Injury and Mortality in Variant B.1.1.7 Positive and Negative SARS-CoV-2 Infection

Öz

Background:This study aimed to compare the acute kidney injury AKI) development and mortality rates in patients with variant B.1.1.7 positive and negative SARS-CoV-2 infection. Material and Methods: 92 variant B.1.1.7 negative (group I) and 57 variant B.1.1.7 positive (group II) SARS-CoV-2 patients were included in the study. Demographic data, comorbidities, the number of intensive care unit hospitalization days, the need for an invasive mechanical ventilator, number of mechanical ventilator days, whether acute renal failure developed, the day of acute renal failure development, and treatment outcome were recorded for each patient. Results: Group II patients (17/57 -29.8%) developed acute kidney injury at a higher rate than group I patients (31/92 -33.7%) (p=0.04).. 46/92 (50%) patients in group I and 38/57 (66.7%) patients in group II received invasive mechanical ventilation support (p <0.05). The mortality rate of patients without AKI development was higher in group II [ 22/40 (55%)] than group I [19/61 (31.2%)] (p<0.05). Conclusion: It was determined that the development of acute kidney injury in patients with critical illness and variant B.1.1.7 infection followed was less than in the other patients. This result suggested that the increase in mortality in variant B.1.1.7 infection occurred independently of the development of acute kidney injury.

Anahtar Kelimeler

• COVID-19
• variant B.1.1.7
• acute kidney injury
• mortality

Kaynakça

1. References: 1. Chaolin Huang , Yeming Wang , Xingwang Li , Lili Ren , Jianping Zhao , Yi Hu , er al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24.
2. 2. Wei-Jie Guan , Zheng-Yi Ni , Yu Hu , Wen-Hua Liang , Chun-Quan Ou , Jian-Xing He , et al. Clinical Characteristics of Coronavirus Disease 2019 in China N Engl J Med. 2020 Apr 30;382(18):1708-1720. doi: 10.1056/NEJMoa2002032. Epub 2020 Feb 28.
3. 3. Fabrizio Fabrizi, Carlo M Alfieri, Roberta Cerutti, Giovanna Lunghi, Piergiorgio Messa COVID-19 and Acute Kidney Injury: A Systematic Review and Meta-Analysis Pathogens. 2020 Dec 15;9(12):1052. doi: 10.3390/pathogens9121052.
4. 4. Xiaobo Yang, Yuan Yu, Jiqian Xu, Huaqing Shu, Jia'an Xia, Hong Liu, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020 May;8(5):475-481. doi: 10.1016/S2213-2600(20)30079-5. Epub 2020 Feb 24.
5. 5. Paul Gabarre, Guillaume Dumas, Thibault Dupont, Michael Darmon, Elie Azoulay, Lara Zafrani. Acute kidney injury in critically ill patients with COVID-19. Intensive Care Med. 2020 Jul;46(7):1339-1348. doi: 10.1007/s00134-020-06153-9. Epub 2020 Jun 12.
6. 6. Zhen Li, Ming Wu, Jiwei Yao, Jie Guo, Xiang Liao, Siji Song, et al. Caution on Kidney Dysfunctions of COVID-19 Patients. doi: https://doi.org/10.1101/2020.02.08.20021212, medRwix.
7. 7. Khwaja A. KDIGO Clinical practice guidelines for acute kidney injury. NephronClinPract. 2012; 120(4):c179–84.
8. 8. Ziying Lei, Huijuan Cao, Yusheng Jie, Zhanlian Huang, Xiaoyan Guo, Junfeng Chen et al. A cross-sectional comparison of epidemiological and clinical features of patients with coronavirus disease (COVID-19) in Wuhan and outside Wuhan, China Travel Med Infect Dis. May-Jun 2020;35:101664. doi: 10.1016/j.tmaid.2020.101664. Epub 2020 Apr 9.

9. 9. Na Zhu, Dingyu Zhang, Wenling Wang, Xingwang Li, Bo Yang, Jingdong Song et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020 Feb 20;382(8):727-733. doi:10.1056/NEJMoa2001017. Epub 2020 Jan 24.
10. 10. Mark S Graham, Carole H Sudre , Anna May, Michela Antonelli, Benjamin Murray, Thomas Varsavsky, er al. Changes in symptomatology, reinfection, and transmissibility associated with the SARS-CoV-2 variant B.1.1.7: an ecological study. Lancet Public Health. 2021 May;6(5):e335-e345. doi: 10.1016/S2468-2667(21)00055-4. Epub 2021 Apr 12.
11. 11. Victor M Corman, Doreen Muth, Daniela Niemeyer, Christian Drosten . Hosts and Sources of Endemic Human Coronaviruses. Adv Virus Res. 2018;100:163-188. doi: 10.1016/bs.aivir.2018.01.001. Epub 2018 Feb 16.
12. 12. Peng Zhou, Xing-Lou Yang, Xian-Guang Wang, Ben Hu, Lei Zhang, Wei Zhang, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020 Mar;579(7798):270-273. doi: 10.1038/s41586-020-2012-7. Epub 2020 Feb 3.
13. 13. Xin Zou, Ke Chen, Jiawei Zou, Peiyi Han, Jie Hao, Zeguang Han. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020 Apr;14(2):185-192. doi: 10.1007/s11684-020-0754-0. Epub 2020 Mar 12.
14. 14. Woon H Chong, Biplab K Saha. Relationship Between Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the Etiology of Acute Kidney Injury (AKI). Am J Med Sci. 2021 Mar;361(3):287-296. doi: 10.1016/j.amjms.2020.10.025. Epub 2020 Oct 27.
15. 15. Luwen Wang, Xun Li, Hui Chen, Shaonan Yan, Dong Li, Yan Li, et al. Coronavirus Disease 19 Infection Does Not Result in Acute Kidney Injury: An Analysis of 116 Hospitalized Patients from Wuhan, China. Am J Nephrol. 2020;51(5):343-348. doi: 10.1159/000507471. Epub 2020 Mar 31.
16. 16. Dawei Wang, Bo Hu, Chang Hu, Fangfang Zhu, Xing Liu, Jing Zhang, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585.
17. 17. Fei Zhou Ting Yu, Ronghui Du Guohui Fan, Ying Liu, Zhibo Liu, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3. Epub 2020 Mar 11.
18. 18. Murugan R, Kellum JA. Acute kidney injury: what’s the prognosis? Nat Rev Nephrol. 2011;7:209–217.
19. 19. Kow CS, Merchant HA, Hasan SS. Mortality risk in patients infected with SARS-CoV-2 of thelineage B.1.1.7 in the UK. J Infect.doi: 10.1016/j.jinf.2021.05.008.
20. 20. Calistri P, Amato L, Puglia I. Infection sustained by lineage B.1.1.7 of SARS-CoV-2 is characterisedbylongerpersistenceandhigherviral RNA loads in nasopharyngealswabs. Int J InfectDis. 2021;105: 753–5.
21. 21. Liu Y, Yan LM, Wan L. Viral dynamics in mild and severe cases of COVID-19. Lancet Infect Dis. 2020;20(6):656–657.
22. 22. Snell LB, Wang W, Alcolea-Medina A, Charalampous, T., Nebbia, G., Batra, R et al. First and second SARS-CoV-2 waves in innerLondon: A comparison of admission characteristics and the impact of the B.1.1.7 variant. medRxiv pre print doi: https://doi.org/10.1101/2021.03.16.21253377.