新型冠状病毒肺炎并发肾损伤机制研究进展
Research Progress on the Mechanism of COVID-19 Complicated with Renal Injury
DOI: 10.12677/ACM.2021.114227, PDF,    科研立项经费支持
作者: 刘 媛：青岛大学医学部，山东 青岛；单文红, 黄俊彦, 许颖川, 季文萱*：青岛大学第二临床医学院，肾内科，山东 青岛
关键词: 新型冠状病毒肺炎；血管紧张素转换酶2；肾损伤；发病机制；综述；COVID-19； ACE-2； AKI； Pathogenesis； Review
摘要: 2019年新型冠状病毒肺炎疫情被世界卫生组织定义为国际突发公共卫生事件，许多感染者死于多脏器衰竭，其中肾损伤是病毒的主要并发症之一。但目前新型冠状病毒肺炎如何导致急性肾损伤的机制尚不清楚，目前认为血管紧张素转换酶2在其中发挥了重要作用。本文梳理了新型冠状病毒的流行病学、感染者相关肾损伤的临床资料，总结了新型冠状病毒并发肾损伤的发生率，提出了可能的发病机制，以供临床决策参考。
Abstract: The epidemic of COVID-19 in 2019 was defined as an international public health emergency by the World Health Organization. Many infected people died of multiple organ failure, among which kidney injury was one of the main complications. However, at present, the mechanism of how COVID-19 leads to acute renal injury is not clear, and it is believed that angiotensin converting enzyme 2 plays an important role. This paper combs the epidemiology of novel coronavirus and the clinical data of renal injury related to infection, summarizes the incidence of novel coronavirus complicated with renal injury, and puts forward the possible pathogenesis, which can be used as a reference for clinical decision-making.
文章引用：刘媛, 单文红, 黄俊彦, 许颖川, 解秀荣, 季文萱. 新型冠状病毒肺炎并发肾损伤机制研究进展[J]. 临床医学进展, 2021, 11(4): 1585-1591. https://doi.org/10.12677/ACM.2021.114227

参考文献

[1] Fehr, A.R. and Perlman, S. (2015) Coronaviruses: An Overview of Their Replication and Pathogenesis. In: Maier, H., Bickerton, E. and Britton, P., Eds., Coronaviruses, Vol. 1282, Humana Press, New York, 1-23. [Google Scholar] [CrossRef] [PubMed]
[2] Li, F. (2016) Structure, Function, and Evolution of Coronavirus Spike Proteins. Annual Review of Virology, 3, 237-261. [Google Scholar] [CrossRef] [PubMed]
[3] Corman, V.M., Eckerle, I., Memish, Z.A., Liljander, A.M., Dijkman, R., Jonsdottir, H., et al. (2016) Link of a Ubiquitous Human Coronavirus to Dromedary Camels. Proceedings of the National Academy of Sciences of the United States of America, 113, 9864-9869. [Google Scholar] [CrossRef] [PubMed]
[4] Xu, J., Zhao, S., Teng, T., Abdalla, A.E., Zhu, W., Xie, L., et al. (2020) Systematic Comparison of Two Animal-to-Human Transmitted Human Coronaviruses: SARS-CoV-2 and SARS-CoV. Viruses, 12, Article No. 244. [Google Scholar] [CrossRef] [PubMed]
[5] WHO (2020) COVID-19 Weekly Epidemiological Update—6 April 2021.
https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---6-april-2021
[6] Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., et al. (2020) Clinical Course and Risk Factors for Mortality of Adult Inpatients with COVID-19 in Wuhan, China: A Retrospective Cohort Study. Lancet, 395, 1054-1062. [Google Scholar] [CrossRef] 
[7] Cheng, Y., Luo, R., Wang, K., Zhang, M., Wang, Z., Dong, L., et al. (2020) Kidney Disease Is Associated with In-Hospital Death of Patients with COVID-19. Kidney International, 97, 829-838. [Google Scholar] [CrossRef] [PubMed]
[8] Richardson, S., Hirsch, J.S., Narasimhan, M., Crawford, J.M., McGinn, T., Davidson, K.W., et al. (2020) Presenting Characteristics, Comorbidities, and Outcomes among 5700 Patients Hospitalized with COVID-19 in the New York City Area. JAMA, 323, 2052-2059. [Google Scholar] [CrossRef] [PubMed]
[9] Gabarre, P., Dumas, G., Dupont, T., Darmon, M., Azoulay, E. and Zafrani, L. (2020) Acute Kidney Injury in Critically Ill Patients with COVID-19. Intensive Care Medicine, 46, 1339-1348. [Google Scholar] [CrossRef] [PubMed]
[10] Chen, R., Liang, W., Jiang, M., Guan, W., Zhan, C., Wang, T., et al. (2020) Risk Factors of Fatal Outcome in Hospitalized Subjects with Coronavirus Disease 2019 from a Nationwide Analysis in China. Chest, 158, 97-105. [Google Scholar] [CrossRef] [PubMed]
[11] Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., et al. (2020) A Novel Coronavirus from Patients with Pneumonia in China, 2019. New England Journal of Medicine, 382, 727-733. [Google Scholar] [CrossRef] 
[12] Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., et al. (2020) Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. New England Journal of Medicine, 382, 1199-1207. [Google Scholar] [CrossRef] 
[13] Zhou, P., Yang, X.-L., Wang, X.-G., Hu, B., Zhang, L., Zhang, W., et al. (2020) A Pneumonia Outbreak Associated with a New Coronavirus of Probable Bat Origin. Nature, 579, 270-273. [Google Scholar] [CrossRef] [PubMed]
[14] Lu, R., Zhao, X., Li, J., Niu, P., Yang, B., Wu, H., et al. (2020) Genomic Characterisation and Epidemiology of 2019 Novel Coronavirus: Implications for Virus Origins and Receptor Binding. Lancet, 395, 565-574. [Google Scholar] [CrossRef] 
[15] Ji, W., Wang, W., Zhao, X., Zai, J. and Li, X. (2020) Cross-Species Transmission of the Newly Identified Coronavirus 2019-nCoV. Journal of Medical Virology, 92, 433-440. [Google Scholar] [CrossRef] [PubMed]
[16] Xu, X., Chen, P., Wang, J., Feng, J., Zhou, H., Li, X., et al. (2020) Evolution of the Novel Coronavirus from the Ongoing Wuhan Outbreak and Modeling of Its Spike Protein for Risk of Human Transmission. Science China Life Sciences, 63, 457-460. [Google Scholar] [CrossRef] [PubMed]
[17] Chan, J.F.-W., Kok, K.-H., Zhu, Z., Chu, H., To, K.K.-W., Yuan, S., et al. (2020) Genomic Characterization of the 2019 Novel Human-Pathogenic Coronavirus Isolated from a Patient with Atypical Pneumonia after Visiting Wuhan. Emerging Microbes & Infections, 9, 221-236. [Google Scholar] [CrossRef] [PubMed]
[18] Liu, Z., Xiao, X., Wei, X., Li, J., Yang, J., Tan, H., et al. (2020) Composition and Divergence of Coronavirus Spike Proteins and Host ACE2 Receptors Predict Potential Intermediate Hosts of SARS-CoV-2. Journal of Medical Virology, 92, 595-601. [Google Scholar] [CrossRef] [PubMed]
[19] Yan, R., Zhang, Y., Li, Y., Xia, L., Guo, Y. and Zhou, Q. (2020) Structural Basis for the Recognition of SARS-CoV-2 by Full-Length Human ACE2. Science, 367, 1444-1448. [Google Scholar] [CrossRef] [PubMed]
[20] Wan, Y., Shang, J., Graham, R., Baric, R.S. and Li, F. (2020) Receptor Recognition by the Novel Coronavirus from Wuhan: An Analysis Based on Decade-Long Structural Studies of SARS Coronavirus. Journal of Virology, 94, e00127-20. [Google Scholar] [CrossRef] 
[21] Wrapp, D., Wang, N., Corbett, K.S., Goldsmith, J.A., Hsieh, C.-L., Abiona, O., et al. (2020) Cryo-EM Structure of the 2019-nCoV Spike in the Prefusion Conformation. Science, 367, 1260-1263. [Google Scholar] [CrossRef] [PubMed]
[22] Zou, X., Chen, K., Zou, J., Han, P., Hao, J. and Han, Z. (2020) Single-Cell RNA-Seqdata Analysis on the Receptor ACE2 Expression Reveals the Potential Risk of Different Human Organs Vulnerable to 2019-nCoV Infection. Frontiers of Medicine, 14, 185-192. [Google Scholar] [CrossRef] [PubMed]
[23] 张明鑫, 路宁, 王佳, 朱琳, 崔曼莉. 新型冠状病毒细胞受体血管紧张素转化酶II在消化道及其肿瘤中的表达[J]. 现代肿瘤医学, 2020, 28(7): 1229-1233.
[24] Chen, Y., Guo, Y., Pan, Y. and Zhao, Z.J. (2020) Structure Analysis of the Receptor Binding of 2019-nCoV. Biochemical and Biophysical Research Communications, 525, 135-140. [Google Scholar] [CrossRef] [PubMed]
[25] Vieira Braga, F.A., Kar, G., Berg, M., Carpaij, O.A., Polanski, K., Simon, L.M., et al. (2019) A Cellular Census of Human Lungs Identifies Novel Cell States in Health and in Asthma. Nature Medicine, 25, 1153-1163. [Google Scholar] [CrossRef] [PubMed]
[26] Deng, Y.Y., Zheng, Y., Cai, G.Y., Chen, X.M. and Hong, Q. (2020) Single-Cell RNA Sequencing Data Suggest a Role for Angiotensin-Converting Enzyme 2 in Kidney Impairment in Patients Infected with 2019-nCoV. Chinese Medical Journal, 133, 1129-1131. [Google Scholar] [CrossRef] 
[27] Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., et al. (2020) Clinical Features of Patients Infected with 2019 Novel Coronavirus in Wuhan, China. Lancet, 395, 497-506. [Google Scholar] [CrossRef] 
[28] Guan, W.-J., Ni, Z.-Y., Hu, Y., Liang, W.-H., Ou, C.-Q., He, J.-X., et al. (2020) Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine, 382, 1708-1720. [Google Scholar] [CrossRef] 
[29] Chen, T., Wu, D., Chen, H., Yan, W., Yang, D., Chen, G., et al. (2020) Clinical Characteristics of 113 Deceased Patients with Coronavirus Disease 2019: Retrospective Study. BMJ, 368, m1091. [Google Scholar] [CrossRef] [PubMed]
[30] Yang, X., Yu, Y., Xu, J., Shu, H., Xia, J., Liu, H., et al. (2020) Clinical Course and Outcomes of Critically Ill Patients with SARS-CoV-2 Pneumonia in Wuhan, China: A Single-Centered, Retrospective, Observational Study. The Lancet Respiratory Medicine, 8, 475-481. [Google Scholar] [CrossRef] 
[31] Ye, M., Wysocki, J., William, J., Soler, M.J., Cokic, I. and Batlle, D. (2006) Glomerular Localization and Expression of Angiotensin-Converting Enzyme 2 and Angiotensin-Converting Enzyme: Implications for Albuminuria in Diabetes. Journal of the American Society of Nephrology, 17, 3067-3075. [Google Scholar] [CrossRef] 
[32] Su, H., Yang, M., Wan, C., Yi, L.X., Tang, F., Zhu, H.Y., et al. (2020) Renal Histopathological Analysis of 26 Postmortem Findings of Patients with COVID-19 in China. Kidney International, 98, 219-227. [Google Scholar] [CrossRef] [PubMed]
[33] Xu, Z., Shi, L., Wang, Y., Zhang, J., Huang, L., Zhang, C., et al. (2020) Pathological Findings of COVID-19 Associated with Acute Respiratory Distress Syndrome. The Lancet Respiratory Medicine, 8, 420-422. [Google Scholar] [CrossRef] 
[34] Bellomo, R., Kellum, J.A., Ronco, C., Wald, R., Martensson, J., Maiden, M., et al. (2017) Acute Kidney Injury in Sepsis. Intensive Care Medicine, 43, 816-828. [Google Scholar] [CrossRef] [PubMed]
[35] Grasselli, G., Zangrillo, A., Zanella, A., Antonelli, M., Cabrini, L., Castelli, A., et al. (2020) Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA, 323, 1574-1581. [Google Scholar] [CrossRef] [PubMed]
[36] Wu, C., Chen, X., Cai, Y., Xia, J., Zhou, X., Xu, S., et al. (2020) Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients with Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Internal Medicine, 180, 934-943. [Google Scholar] [CrossRef] [PubMed]
[37] Holshue, M.L., DeBolt, C., Lindquist, S., Lofy, K.H., Wiesman, J., Bruce, H., et al. (2020) First Case of 2019 Novel Coronavirus in the United States. New England Journal of Medicine, 382, 929-936. [Google Scholar] [CrossRef] 
[38] Grein, J., Ohmagari, N., Shin, D., Diaz, G., Asperges, E., Castagna, A., et al. (2020) Compassionate Use of Remdesivir for Patients with Severe Covid-19. New England Journal of Medicine, 382, 2327-2236. [Google Scholar] [CrossRef] 
[39] Savarino, A., Boelaert, J.R., Cassone, A., Majori, G. and Cauda, R. (2003) Effects of Chloroquine on Viral Infections: An Old Drug against Today’s Diseases? The Lancet Infectious Diseases, 3, 722-727. [Google Scholar] [CrossRef] 
[40] Wang, M., Cao, R., Zhang, L., Yang, X., Liu, J., Xu, M., et al. (2020) Remdesivir and Chloroquine Effectively Inhibit the Recently Emerged Novel Coronavirus (2019-nCoV) in Vitro. Cell Research, 30, 269-271. [Google Scholar] [CrossRef] [PubMed]
[41] Gao, J., Tian, Z. and Yang, X. (2020) Breakthrough: Chloroquine Phosphate Has Shown Apparent Efficacy in Treatment of COVID-19 Associated Pneumonia in Clinical Studies. Bioscience Trends, 14, 72-73.
[42] Shen, C., Wang, Z., Zhao, F., Yang, Y., Li, J., Yuan, J., et al. (2020) Treatment of 5 Critically Ill Patients with COVID-19 with Convalescent Plasma. JAMA, 323, 1582-1589. [Google Scholar] [CrossRef] [PubMed]
[43] Liu, X., Liu, C., Liu, G., Luo, W. and Xia, N. (2020) COVID-19: Progress in Diagnostics, Therapy and Vaccination. Theranostics, 10, 7821-7835. [Google Scholar] [CrossRef] [PubMed]
[44] Zhang, Y., Zeng, G., Pan, H., Li, C., Hu, Y., Chu, K., et al. (2021) Safety, Tolerability, and Immunogenicity of an Inactivated SARS-CoV-2 Vaccine in Healthy Adults Aged 18-59 Years: A Randomised, Double-Blind, Placebo-Controlled, Phase 1/2 Clinical Trial. The Lancet Infectious Diseases, 21, 181-192. [Google Scholar] [CrossRef] 
[45] Zhu, F.C., Li, Y.H., Guan, X.H., Hou, L.H., Wang, W.J., Li, J.X., et al. (2020) Safety, Tolerability, and Immunogenicity of a Recombinant Adenovirus Type-5 Vectored COVID-19 Vaccine: A Dose-Escalation, Open-Label, Non-Randomised, First-in-Human Trial. Lancet, 395, 1845-1854. [Google Scholar] [CrossRef] 
[46] Zhu, F.C., Guan, X.H., Li, Y.H., Huang, J.Y., Jiang, T., Hou, L.H., et al. (2020) Immunogenicity and Safety of a Recombinant Adenovirus Type-5-Vectored COVID-19 Vaccine in Healthy Adults Aged 18 Years or Older: A Randomised, Double-Blind, Placebo-Controlled, Phase 2 Trial. Lancet, 396, 479-488. [Google Scholar] [CrossRef] 

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