Coronavirus disease 2019 in chronic kidney disease
D'Marco, Luis (Hospital Clínic Universitari (València))
Puchades, María Jesús (Hospital Clínic Universitari (València))
Romero Parra, María (Hospital Clínic Universitari (València))
Gimenez Civera, Elena (Hospital Clínic Universitari (València))
Soler, María José (Hospital Universitari Vall d'Hebron)
Ortiz, Alberto (Universidad Autónoma de Madrid)
Górriz, Jose Luis (Hospital Clínic Universitari (València))
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	The clinical spectrum of coronavirus disease 2019 (COVID-19) infection ranges from asymptomatic infection to severe pneumonia with respiratory failure and even death. More severe cases with higher mortality have been reported in older patients and in those with chronic illness such as hypertension, diabetes or cardiovascular diseases. In this regard, patients with chronic kidney disease (CKD) have a higher rate of all-type infections and cardiovascular disease than the general population. A markedly altered immune system and immunosuppressed state may predispose CKD patients to infectious complications. Likewise, they have a state of chronic systemic inflammation that may increase their morbidity and mortality. In this review we discuss the chronic immunologic changes observed in CKD patients, the risk of COVID-19 infections and the clinical implications for and specific COVID-19 therapy in CKD patients. Indeed, the risk for severe COVID-19 is 3-fold higher in CKD than in non-CKD patients; CKD is 12-fold more frequent in intensive care unit than in non-hospitalized COVID-19 patients, and this ratio is higher than for diabetes or cardiovascular disease; and acute COVID-19 mortality is 15-25% for haemodialysis patients even when not developing pneumonia.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Cardiovascular disease ; Chronic kidney disease ; COVID-19 ; Immunity ; SARS-CoV-2 ; Therapy
Published in:	Clinical Kidney Journal, Vol. 13 (july 2020) , p. 297-306, ISSN 2048-8513

DOI: 10.1093/ckj/sfaa104
PMID: 32699615

10 p, 1.2 MB

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