The Hypothesis of the COVID-19 Role in Acute kidney Injury: A Literatures Review

Coronavirus disease 2019 (COVID-2019) is a viral infection that mainly causes pulmonary infection. Still, mortality usually occurs in patients with comorbidities, such as chronic kidney disease (CKD), which accounts for over 20% of mortalities, morbid obesity, immunosuppression, diabetes mellitus, hypertension, and cancer. Also, the incidence of acute kidney failure was reported to be 5-10% in outpatient series and up to 50% in patients that need to be admitted to the intensive care unit. It is important to know that acute kidney injury (AKI) is associated with increased mortality, so this essay will review possible mechanisms that result in AKI. Based on the multifactorial mechanism of AKI, we should have considered probable causes of AKI and acted stepwise to tackle these mechanisms and improve the ultimate prognosis of patients. Although most of the measures are supportive, in some patients, such as severely ill cases, cytokine storm may be attributed to the severity of symptoms, so immunomodulatory treatments could decrease AKI and mortality. Among hypotheses that propose AKI, a virus’s pre-renal and direct renal involvement are discussed in detail.