Urinary SARS-CoV-2 RNA Is an Indicator for the Progression and Prognosis of COVID-19

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 sedimen...

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Autores principales:	Lu Zhang, Maoqing Tian, Yuan Song, Wei Liang, Xiaogang Li, Yongqing Tong, Huiming Wang
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	COVID-19 SARS-CoV-2 endothelium renal pathology indicator Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/2b6712f718834667892be5af95f5bfb7
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spelling	oai:doaj.org-article:2b6712f718834667892be5af95f5bfb72021-11-25T17:21:32ZUrinary SARS-CoV-2 RNA Is an Indicator for the Progression and Prognosis of COVID-1910.3390/diagnostics111120892075-4418https://doaj.org/article/2b6712f718834667892be5af95f5bfb72021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2089https://doaj.org/toc/2075-4418Background: 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%, <i>p</i> = 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.Lu ZhangMaoqing TianYuan SongWei LiangXiaogang LiYongqing TongHuiming WangMDPI AGarticleCOVID-19SARS-CoV-2endotheliumrenal pathologyindicatorMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2089, p 2089 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 SARS-CoV-2 endothelium renal pathology indicator Medicine (General) R5-920
spellingShingle	COVID-19 SARS-CoV-2 endothelium renal pathology indicator Medicine (General) R5-920 Lu Zhang Maoqing Tian Yuan Song Wei Liang Xiaogang Li Yongqing Tong Huiming Wang Urinary SARS-CoV-2 RNA Is an Indicator for the Progression and Prognosis of COVID-19
description	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%, <i>p</i> = 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.
format	article
author	Lu Zhang Maoqing Tian Yuan Song Wei Liang Xiaogang Li Yongqing Tong Huiming Wang
author_facet	Lu Zhang Maoqing Tian Yuan Song Wei Liang Xiaogang Li Yongqing Tong Huiming Wang
author_sort	Lu Zhang
title	Urinary SARS-CoV-2 RNA Is an Indicator for the Progression and Prognosis of COVID-19
title_short	Urinary SARS-CoV-2 RNA Is an Indicator for the Progression and Prognosis of COVID-19
title_full	Urinary SARS-CoV-2 RNA Is an Indicator for the Progression and Prognosis of COVID-19
title_fullStr	Urinary SARS-CoV-2 RNA Is an Indicator for the Progression and Prognosis of COVID-19
title_full_unstemmed	Urinary SARS-CoV-2 RNA Is an Indicator for the Progression and Prognosis of COVID-19
title_sort	urinary sars-cov-2 rna is an indicator for the progression and prognosis of covid-19
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/2b6712f718834667892be5af95f5bfb7
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Urinary SARS-CoV-2 RNA Is an Indicator for the Progression and Prognosis of COVID-19

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