Renal Biomarkers in AKI and COVID-19
Renal Biomarkers in AKI and COVID-19
Severe pneumoniae related to Coronavirus Disease (COVID-19), had a high in-hospital
 mortality; this condition are worst in subjects with acute kidney disease (AKI); conditioning
 increased mortality, days of assisted mechanical ventilation (AMV), increased nosocomial
 infections and high costs. We need many studies for determinated the risk factors for AKI in
 subjects with COVID-19.

 This study pretends identify the incidence of AKI in subjects with severe pneumoniae by
 COVID-19, describe the role of some biomarkers in the physiopathology of AKI-COVID-19; and
 determine the evolution of urinary biomarkers during hospitalization, like neutrophil
 gelatinase-associated lipocalin (NGAL), tissue inhibitor of metalloproteinases-2 (TIMP-2),
 insulin-like growth factor binding protein-7 (IGFBP7), and interleukin-6 (IL-6) and the
 progression of viruria of Severe Acute Respiratory Syndrome (SARS) related to CoronaVirus 2
 (CoV2) in subjects with or without AKI.
The usefulness of urinary NGAL levels and the platelet / lymphocyte index as predictive
 markers of AKI in the context of COVID-19 will be studied. These results will allow to
 propose more appropriate strategies for the prevention, diagnosis and timely management of
 patients with severe pneumonia due to COVID-19 and AKI. Knowing the viral load in urine and
 its evolution in patients with and without AKI will allow us to explore associations between
 the presence of the virus at the local level and the presence of kidney damage. Likewise, the
 presence of viral load in urine and its possible relationship with the local activation of
 the complement system, together with the detection of biomarkers of kidney damage, like NGAL,
 TIMP-2, IGFBP7, and IL-6, will allow us to better understand the pathophysiology of these
 alterations in the context of COVID-19; additionally, some patients received tocilizumab, an
 IL-6 inhibitor as a compassionate measure, which may reduce urinary levels of interleukins
 and other inflammatory markers.

 Finally, the study of possible differences in the metabolome in urine in patients with and
 without acute kidney injury could favor the discovery of new markers to identify patients
 with SARS-CoV-2 infection susceptible to the development of AKI.

 Determine the evolution of NGAL, TIMP-2, IGFBP7, IL-6, viral load and metabolomic basal, and
 the days 3 , 5 and 7 after recruitment
Inclusion Criteria:

 -  Subjects over 18 years of age.

 -  Subjects admitted with a diagnosis of probable SARS-CoV-2 pneumonia.

 -  Subjects with a diagnosis of SARS-CoV-2 pneumonia confirmed by Real-time
 quantitative-Polymerase Chain Reaction (qRT-PCR).

 -  Subjects with qRT-PCR negative for SARS-CoV-2, but who meet clinical and radiological
 criteria for COVID-19, and no other causes have been identified.

 Exclusion Criteria:

 -  Pregnant women

 -  Incomplete medical records.

 Elimination criteria:

 -  Patients who die within the first 24 hours of entering the institute.

 -  Patients discharged for any reason not considered death within the first 48 hours,
 such as voluntary discharge or transfer to other health institutions.

 -  Patients who during their hospitalization report a positive PCR for other
 non-respiratory viruses without identifying SARS-CoV-2

 -  Patients who withdraw their consent