Evaluation of urine SARS-COV-2 RT-PCR as a predictor of acute kidney injury and disease severity in patients with critical COVID-19

  1. Sérgio Pinto de Souza
  2. Marcelo Augusto Duarte Silveira
  3. Bruno Solano de Freitas Souza
  4. Julia Barros Cabral
  5. Erica Batista dos Santos Galvão de Melo
  6. Carolina Kymie Vasques Nonaka
  7. Fernanda Oliveira Coelho
  8. Rogério da Hora Passos

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Abstract

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which began as an outbreak in Wuhan, China and has spread rapidly across the globe. Although most infections are mild, patients with severe and critical COVID-19 infections face deterioration of respiratory function and may also have extrapulmonary manifestations, mostly affecting the kidney, digestive tract, heart, and nervous system. Here, we prospectively evaluated the presence of SARS-CoV-2 genetic material using reverse-transcription polymerase chain reaction in urine samples obtained from patients with COVID-19 receiving critical care. Among 51 included patients, we found higher serum creatinine levels, a longer hospital stay, and more frequent need for dialysis 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.

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  1. Version published to 10.1177/03000605211015555
  2. ScreenIT

    SciScore for 10.1101/2021.01.13.21249576: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethics statement: 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).
    Consent: All participants gave informed consent.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has some limitations. It was a single center, observational study with a limited number of participants. We also did not successfully obtain follow-up urine specimens, as the majority of AKI patients already had AKI upon enrollment in the study. In summary, we searched prospectively the urine of COVID-19 patients for the SARS-CoV-2 RNA, and found a relatively low incidence of this finding, which does not support a relevant role for cytopathic viral effects in the majority of AKI patients. However, the subgroup of patients who tested positive for SARS-CoV-2 in urine samples presented a higher frequency of diabetes and hypertension. In this subgroup, the association of higher serum creatinine levels, a longer hospital stay and a more frequent dialysis need were found. These findings, although preliminary, lead to the speculation that, in predisposed patients, a direct viral cytopathic effect could contribute to a more severe phenotype. Disclosure: All the authors declare no competing interests.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2021.01.13.21249576v1 on medRxiv