Search

Background The SARS-CoV-2 pandemic has become the most serious health problem of today globally. Kidney involvement in patients with coronavirus disease 2019 (COVID-19) is common and associated with high mortality. Although acute tubular necrosis due to hemodynamic instability is the most common cause, other complex and destructive processes related to cytokine storm and activation of innate and adaptive immunity have also been reported. Case presentation: Herein, we present successful treatment of proteinase-3 anti-neutrophil cytoplasmic antibodies (PR3-ANCA)-associated vasculitis case presenting with severe pulmonary-renal syndrome as a rare and fatal complication of COVID-19 infection. Conclusions AAV is a serious disease and prompt treatment is one of the most important factors in patient survival.

BACKGROUND AND AIMS The SARS-CoV-2 pandemic has become one of the most serious health problems globally. Covid-19 poses a serious life-threatening risk, especially for immunocompromised patients such as kidney transplant recipients. However, the reason why some transplant recipients are asymptomatic while others are severely ill is still not clear. Genetic variation might affect the outcome and mortality of Covid-19 infection. Haptoglobin (Hp) is a plasma protein with antioxidant, immunomodulatory properties and has an important biological function in the host defense responses to infection and inflammation [1]. In humans, Hp is characterized by a molecular heterogeneity with three main genotypes/phenotypes: Hp1-1, Hp2-1, and Hp2-2 [2, 3]. This polymorphism might have important biological consequences in various bacterial and viral infections [3, 4]. In the present study, we aimed to evaluate whether haptoglobin gene polymorphisms effect Covid-19’s severity in kidney transplant patients. METHOD About 229 renal transplant recipients were evaluated in retrospective fashion. Patients with a history of Covid-19 infection (n:62) were included in the study. We investigated the relation between Hp phenotypes (Hp 1–1, Hp 1–2, Hp 2–2) and Covid-19 disease severity. RESULTS Baseline characteristics, laboratory and health parameters were similar between Hp 1–1, Hp 1–2 and Hp 2–2 groups. We found that Hp2-2 phenotype was a significant predictor of disease severity in renal transplant recipients with Covid-19 (p:0013). Hp 2–2 phenotype was significantly associated with longer hospitalizations and intensive care unit admissions (p:0012 and p:0032). CONCLUSION Renal transplant recipients with the Hp 2–2 phenotype might have worse outcomes with Covid-19. It has been suggested that the Hp2-2 phenotype predisposes to greater oxidative stress and more pronounced viral replication [5]. Thus, the HP 1–1 protein has been described superior antioxidant and anti-inflammatory properties compared with the other two genotypes. This difference and geographic variation in haptoglobin phenotypes may be one of the factors contributing to the geographical variation in Covid-19 disease severity and mortality. Hp phenotype may be useful in the risk stratification algorithm and management of Covid-19. Studies involving more patients will be welcome to enlighten Hp genes effect on this subject.

BACKGROUND AND AIMS There is not enough data on the post-COVID-19 (coronavirus disease 2019) period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data retrospectively obtained in the follow-up of PD patients after COVID-19 with a control PD group. METHOD This study, supported by the Turkish Society of Nephrology, is a national multicenter retrospectively case–control study involving adult PD patients with confirmed COVID-19, using data collected from 21 April 2021 to 11 June 2021. A control PD group was also formed from each PD unit, from patients with similar characteristics but who did not have COVID-19. Patients in the active period of COVID-19 were not included. Data at the end of the first month and within the first 90 days, as well as other outcomes, including mortality, were investigated. RESULTS A total of 223 patients (COVID-19 group: 113, control group: 110) from 28 centers were included. The duration of PD in both groups was similar [median (IQR):3.0 (1.88–6.0) years and 3.0 (2.0–5.6)], but the patient age of the COVID-19 group was lower than the control group [50 (IQR:40–57) years and 56 (IQR:46–64) years, P CONCLUSION Mortality in the first 90 days after COVID-19 in PD patients with COVID-19 is not different from the control PD group. However, some of these patients continue to experience significant problems, especially respiratory system symptoms, malnutrition, and hypervolemia.

BACKGROUND AND AIMS Haemodialysis (HD) patients are at increased risk for adverse short-term consequences of COVID-19. In this study, we investigated the characteristics of chronic HD patients in the post-COVID-19 period and compared them with the control group. METHOD We conducted a national multicentre observational study involving adult chronic HD patients recovering from COVID-19. The control HD group was selected from patients with similar characteristics who did not have COVID-19 in the same center. SARS-CoV-2 RT-PCR negative patients and patients in the active period of COVID-19 were not included. RESULTS A total of 1223 patients (635 COVID-19 groups, 588 control groups) were included in the study from the data collected from 47 centres between 21 April 2021 and 11 June 2021. The patients' baseline demographics, comorbidities, medications, HD characteristics and basic laboratory tests were quite similar between the groups (Table 1). 28th-day mortality and between 28th day and 90th day mortality were higher in the COVID-19 group than in the control group [19 (3.0%) patients and 0 (0%) patients; 15 (2.4%) patients and 4 (0.7%) patients, respectively]. Presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection and A-V fistula thrombosis were significantly higher in the COVID-19 group in the first 28 days of illness and between 28 and 90 days. Mortality was significantly associated with preexisting COVID-19, age, current smoking, use of tunneled HD catheter, persistence of respiratory symptoms, rehospitalization, need for home oxygen support, presence of lower respiratory tract infection within 28 days and persistence of respiratory symptoms. CONCLUSION In the post-COVID-19 period, mortality, rehospitalization, respiratory problems and vascular access problems are higher in maintenance HD patients who have had COVID-19 compared to control HD patients. Table 2. Comparative presentation of patients data on the 28th day and between 28 and 90 day COVID-19 groupN = 635 Control groupN = 588 28th-day results, n(%) Death* 19(3.0) 0(0) Any respiratory symptoms* 152(23.9) 11(1.9) Rehospitalization for any reason* 52(8.2) 24(4.1) Need for home oxygen support * 26(4.1) 2(0.3) Lower respiratory tract infection* 65(10.2) 8(1.4) AV fistula thrombosis* 13(2.0) 2(0.3) Other thromboembolic events * 15(2.4) 4(0.7) Need for HD catheter placement* 21(3.3) 9(1.5) 28th day-90. day resultsa n(%) N:616 N:588 Death* 15(2.4) 4(0.7) Any respiratory symptoms* 45(7.3) 10(1.7) Rehospitalization for any reason* 44(7.1) 18(3.1) Need for home oxygen support* 12(1.9) 2(0.3) AV fistula thrombosis* 9(1.5) 1(0.2) Other thromboembolic events* 9(1.5) 2(0.3) Need for HD catheter placement 13(2.1) 10(1.7) HD: haemodialysis, AV: arteriovenous. *P

Introduction: There are not enough data on the post-CO-VID-19 period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data of PD patients after COVID-19 with a control PD group. Methods: This study, supported by the Turkish Society of Nephrology, is a national, multicenter retrospective case-control study involving adult PD patients with confirmed COVID-19, using data collected from April 21, 2021, to June 11, 2021. A control PD group was also formed from each PD unit, from patients with similar characteristics but without COVID-19. Patients in the active period of COVID-19 were not included. Data at the end of the first month and within the first 90 days, as well as other outcomes, including mortality, were investigated. Results: A total of 223 patients (COVID-19 group: 113, control group: 110) from 27 centers were included. The duration of PD in both groups was similar (median [IQR]: 3.0 [1.88-6.0] years and 3.0 [2.0-5.6]), but the patient age in the COVID-19 group was lower than that in the control group (50 [IQR: 40-57] years and 56 [IQR: 46-64] years, p < 0.001). PD characteristics and baseline laboratory data were similar in both groups, except serum albumin and hemoglobin levels on day 28, which were significantly lower in the COVID-19 group. In the COVID-19 group, respiratory symptoms, rehospitalization, lower respiratory tract infection, change in PD modality, UF failure, and hypervolemia were significantly higher on the 28th day. There was no significant difference in laboratory parameters at day 90. Only 1 (0.9%) patient in the COVID-19 group died within 90 days. There was no death in the control group. Respiratory symptoms, malnutrition, and hypervolemia were significantly higher at day 90 in the COVID-19 group. Conclusion: Mortality in the first 90 days after COVID-19 in PD patients with COVID-19 was not different from the control PD group. However, some patients continued to experience significant problems, especially respiratory system symptoms, malnutrition, and hypervolemia. © 2022 S. Karger AG, Basel. Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

Introduction: Hemodialysis (HD) patients have increased risk for short-term adverse outcomes of COVID-19. However, complications and survival at the post-COVID-19 period have not been published extensively.Methods: We conducted a national, multicenter observational study that included adult maintenance HD patients recovered from confirmed COVID-19. A control HD group without COVID-19 was selected from patients in the same center. We investigated the characteristics and outcomes in the follow-up of HD patients and compare them with the non-COVID-19 group.Results: A total of 1223 patients (635 patients in COVID-19 group, 588 patients in non-COVID-19 group) from 47 centers were included in the study. The patients' baseline and HD characteristics were almost similar. The 28th-day mortality and mortality between 28th day and 90th day were higher in the COVID-19 group than non-COVID-19 group (19 [3.0%] patients vs. none [0%]; 15 [2.4%] patients vs. 4 [0.7%] patients, respectively). The presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection, and arteriovenous (AV) fistula thrombosis was significantly higher in the COVID-19 group in both the first 28 days and between 28 and 90 days. In the multivariable analysis, age (odds ratio [OR] [95% CI]: 1.029 [1.004-1.056]), group (COVID-19 group vs. non-COVID-19 group) (OR [95% CI]: 7.258 [2.538-20.751]), and vascular access type (tunneled catheter/AV fistula) (OR [95% CI]: 2.512 [1.249-5.051]) were found as independent parameters related to 90-day mortality.Conclusion: In the post-COVID-19 period, maintenance HD patients who have had COVID-19 have increased rehospitalization, respiratory problems, vascular access problems, and high mortality compared with the non-COVID-19 HD patients.

Background In this study, we evaluated 3-month clinical outcomes of kidney transplant recipients (KTR) recovering from COVID-19 and compared them with a control group. Method The primary endpoint was death in the third month. Secondary endpoints were ongoing respiratory symptoms, need for home oxygen therapy, rehospitalization for any reason, lower respiratory tract infection, urinary tract infection, biopsy-proven acute rejection, venous/arterial thromboembolic event, cytomegalovirus (CMV) infection/disease and BK viruria/viremia at 3 months. Results A total of 944 KTR from 29 different centers were included in this study (523 patients in the COVID-19 group; 421 patients in the control group). The mean age was 46 ± 12 years (interquartile range 37–55) and 532 (56.4%) of them were male. Total number of deaths was 8 [7 (1.3%) in COVID-19 group, 1 (0.2%) in control group; P = 0.082]. The proportion of patients with ongoing respiratory symptoms [43 (8.2%) versus 4 (1.0%); P Conclusion The prevalence of ongoing respiratory symptoms increased in the first 3 months post-COVID in KTRs who have recovered from COVID-19, but mortality was not significantly different.

In this work, poly(HEMA–APH) nanoparticles were synthesized by surfactant-free emulsion polymerization technique. Magnetic behaviour was introduced by simple addition of Fe3O4 into the polymerization medium. Characterization of the nanoparticle was carried out by FTIR, ESR, SEM, AFM and EDX analyses. These synthesized magnetic nanoparticles were used for adsorption of lysozyme. For this purpose, adsorption conditions were optimized and maximum lysozyme binding capacity was found to be 278.8 mg g−1 polymer in pH 7.0 phosphate buffer at 25∘C. Desorption and reusability properties of the nanoparticles were investigated and lysozyme adsorption efficiency did not change significantly at the end of the 10 successive reuses.