COVID-19 Kab Mob Thiab Lub raum: Kawm Cov Lus Qhia
Mar 10, 2022
TSAB NTAWV
Tus kab mob coronavirus tshiab 2019 tau dhau los ua kev noj qab haus huv thoob ntiaj teb. Nyob rau hauv ib qho kev sim decipher li caslub raumraug cuam tshuam los ntawm tus kab mob COVID-19, qhov kev tshuaj xyuas no tsom mus rau cov kab mob thiab cov chaw kho mob txuas ntawm COVID-19 kab mob thiablub raum. SARS-CoV-2 cov neeg mob uas muaj kab mob yog tsom raumob raum, lub raum tropism, ntawm lwm yam teeb meem ntawm lub cev. COVID-19 cuam tshuamraumkev hlub tau tshaj tawm tsis yog nyob rau hauv tus kab mob ntevmob raum cov neeg mob tab sis kuj nyob rau hauv cov neeg uas tsis muaj keeb kwm yav dhau los ntawmmob raum.Raws li nephrologists sim ua kom nrawm nrawm, qee zaum nrawm, ceeb toom txog kev mob raum hauv COVID-19,lub raumtxuas ntxiv raug cuam tshuam los ntawm kev cuam tshuam, tshwj xeeb tshaj yog nyob rau hauv cov chaw kho mob tseem ceeb. Qhov kev tshuaj xyuas no yog tsom qhia luv luv piav qhia txog kev cuam tshuam rau lub raum hauv COVID-19 nyob rau hauv qhov tsis tau muaj dua los ntawm cov ntaub ntawv tshawb fawb. Raws li tau txais kev paub thiab kev txawj ntse, nws yog qhov tsim nyog los tsim thiab hloov kho cov tswv yim tiv thaiv, kuaj mob thiab kho cov tswv yim los txhim kho cov txiaj ntsig kho mob thiab txo cov neeg tuag.
Taw qhia
COVID-19 yog ib yam kab mob tshiab uas tshwm sim hauv tib neeg txoj kev kis tus kab mob uas yog qhov pib ntawm xyoo thib peb ntawm xyoo pua 21st. Tus kab mob coronavirus tshiab uas ua rau COVID-19 tau raug xaiv los ntawm tus mob hnyav ua pa nyuaj ua rau tus mob coronavirus 2 (SARS-CoV-2). . COVID-19 cuam tshuam rau ntau lub tebchaws thoob plaws ntiaj teb thiab tau tshaj tawm rau txhua lub hnub nyoog, suav nrog menyuam yaus [1]. Thaum Lub Peb Hlis 11, 2020, WHO tau tshaj tawm COVID{10}} tus kabmob kis thoob qhov txhia chaw tom qab tau piav qhia los ntawm WHO rau 23rd ntawm Lub Peb Hlis yog "tus kabmob kis tau nrawm dua" thaum kis tus kabmob 350,000. Txog niaj hnub no, cov neeg mob thoob ntiaj teb nce siab dua 116 lab thiab tuag ntau dua 2.5 lab [2]. Coronaviruses (CoV) yog tsiaj thiab tib neeg cov kab mob uas tuaj yeem ua rau tuag taus zoonotic. CoV muaj qhov tshwj xeeb morphology nrog cov ntoo zoo li cov pob txha ntawm lawv qhov chaw, yog li lub npe "corona". Xyoo 2003, CoV tau txais kev saib xyuas ntau yam ua rau muaj tus kab mob ua pa hnyav. Txij li xyoo 2003, SARS-CoV-2 yog qhov tshwm sim thib peb ntawm CoV tus kab mob nrog cov kab mob ua pa hnyav tom qab mob hnyav ua pa mob coronavirus (SARS-CoV) hauv xyoo 2003 thiab Middle East respiratory syndrome coronavirus (MERS-CoV) hauv xyoo 2012. [3–5]. COVID{29}} tus kab mob kis thoob qhov txhia chaw tau cuam tshuam rau txhua tus, tab sis nws qhov cuam tshuam rau cov neeg mob txuas ntxiv mus. Txog rau tam sim no, kev nkag siab ntawm nws cov kab mob sib kis, pathogenesis thiab kev kho mob tshwm sim tseem tab tom hloov zuj zus. Cov kws tshawb fawb thiab cov kws tshawb fawb thoob plaws ntiaj teb tab tom kawm txog tus kab mob no kom nthuav dav cov kev paub txog kev tshawb fawb tsis ntev los no ntawm tus kab mob tshiab no. Txawm hais tias COVID-19 feem ntau cuam tshuam nrog lub ntsws uas tshwm sim raws li tus kab mob ua pa hnyav, tau tshaj tawm lwm qhov kev koom tes hauv nruab nrog cev suav nrograum,gastrointestinal ib ntsuj av, daim siab, lub plawv, thiab central nervous system. Yog li ntawd, tus kab mob tshiab coronavirus 2019 kis thoob qhov txhia chaw tau ua rau muaj kev ceeb toom tsis tau pom dua ntawm yuav luag txhua qhov kev saib xyuas kev noj qab haus huv suav nrog nephrology [6–8].
Ntsiab lus:SARS-CoV-2, pathogenesis; Mob raum raug mob; Dialysis; Kev hloov pauv; Kev kuaj mob
CISTANCHE yuav txhim kho rau lub raum/ raum mob
Pathogenesis
SARS-CoV-2 has an identical confining structure to that of SARS-CoV-1, li no COVID-19 pathogenesis loj zoo ib yam li SARS-CoV-1. SARS-CoV-2 spike glycoprotein nthuav tawm ntawm lub hnab ntawv viral khi angiotensin-hloov enzyme 2 (ACE2) nrog ib ncig ntawm 10 npaug ntau dua affinity dua SARS-CoV1. ACE2 tau paub tias tau nthuav tawm ntau ntau ntawm cov hlwb ntau ciliated ntawm cov hlab ntsws epithelium uas SARS-CoV-2 nyiam kis. Tom qab khi, SARS-CoV-2 nkag mus rau hauv cov cell uas nws ntsib lub cev tiv thaiv kab mob. Nws kis tus tswv tsev tshiab los ntawm inhibiting lossis eluding nws lub cev tiv thaiv kab mob. Txawm li cas los xij, yuav ua li cas SARS-CoV-2 tswj kom tshem tawm lub cev tiv thaiv kab mob thiab tsav cov kab mob tseem tsis tau paub meej [9]. SARS-CoV-2 ua rau cov kab mob hauv cov kab mob epithelial ntawm cov pa ua pa ua rau cov teebmeem cytopathic thiab ciliary tsis ua haujlwm [10]. Lub cytokine cua daj cua dub ua rau muaj mob hnyav nrog qhov mob hnyav hnyav uas pib lub hom phiaj macrophages, lymphocytes thiab pneumocytes. Raws li SARS-CoV-2 nkag mus rau hauv lub cell nws yuav siv sij hawm tswj lub endogenous transcriptional machinery ntawm alveolar hlwb kom replicate thiab kis mus rau tag nrho cov ntsws ntsws [8,11]. Thaum feem ntau ntawm cov cell ciliated nyob rau hauv alveoli tau kis, lawv tsis ua nws txoj haujlwm ntawm kev tshem tawm cov pa, nrog kev nce ntxiv ntawm cov khib nyiab thiab kua hauv lub ntsws thiab mob ua pa nyuaj (ARDS) [12]. Kev tso tawm ntau dhau ntawm plasminogen activators vim yog qhov mob ua rau mob endothelial cell raug mob tuaj yeem piav qhia txog cov khoom siv d-dimer thiab fibrin degradation siab hauv cov neeg mob uas muaj tus kab mob COVID{34}} [13]. Cov ntawv ceeb toom tom qab kev kuaj mob tau lees paub tias muaj cov ntshav txhaws ntxiv thiab nthuav tawm cov kab mob intravascular coagulation nrog microvascular thrombosis thiab pulmonary infarction [14]. Nws tau raug pom tias qhov kev puas tsuaj hauv zos ntawm qhov sib npaug ntawm tus tswv coagulation thiab fibrinolytic txoj hauv kev nyob rau hauv alveolar qhov chaw yog qhov ua rau muaj kev txhim kho loj heev los ntawm vasoconstriction thiab cov ntshav txo qis vim yog qhov mob hypoxemia hauv pulmonary capillaries [13] Qee tus neeg mob COVID-19, microangiopathy tau lees paub hauv lwm cov kabmob ua rau splenic infarction, lub raum infarction thiab myocardial raug mob tej zaum vim yog myocarditis thiab microangiopathy [15].
Pathogenesis ntawm lub raum raug mobTxawm hais tias lub raum kev koom tes hauv COVID-19 tau raug tshaj tawm, qhov spectrum ntawmmob raumua kom nthuav dav thiab nthuav dav. Yuav ua li caslub raumkoom nrog hauv COVID-19 tseem tsis tau meej meej, txawm li cas los xij, kev sib cuam tshuam ntawm cov txheej txheem hauv qab no tau raug tso tawm:
1) Kev raug mob ntawm tes ncaj qha nrog kev hloov pauv ntawm cov metabolism hauv kev puas tsuaj thiab ua kom txoj hauv kev catabolic ua rau muaj kev cuam tshuam loj heev thiab tswj tsis tau electrolyte derangement [16]. ACE2 qhia txog lub raum tubular hlwb thiab podocytes tau txheeb xyuas tias yog tus khub sib koom ua ke rau SARS-CoV-2 kab mob. Yog li COVID-19 kho mob angiotensin II tsub zuj zuj tuaj yeem txhawb kev ua kom RAAS tsis txaus, ua rau mob, fibrosis thiab vasoconstriction [17]. Viral RNA tau raug txheeb xyuas yav dhau los hauvraumtissue and urine in SARS-CoV infection [18]. Ntxiv mus, tsis ntev los no cov ntawv ceeb toom ntawm SARS-CoV-2 cais tawm ntawm cov zis ntawm tus neeg mob; and immunohistochemical identification of accumulated SARS-CoV-2 nucleocapsid antigen inraumtubular cell, ua rauraumraws li lub hom phiaj ua tau ntawm tus kabmob tshiab no [19,20]. Tsis ntev los no tib neeg cov ntaub so ntswg RNA-sequencing cov ntaub ntawv qhiaraumenrichment nrog ACE2, transmembrane serine protease 2 (TMPRSS2), thiab cathepsin L (CTSL) noob uas pab SARSCoV-2 kab mob yog li ua rau lubrauma particular target for SARS-CoV-2–sociatedmob raum [21,22].
CISTANCHE yuav txhim kho lub raum / raum kab mob
2) Inflammatory and immune over-reaction is characterized by an enhanced release of circulating mediators. Cov neeg mob hnyav tau muaj ntau dua cov ntshav plasma ntawm TNF; IFN- -induced protein 10 (IP10); macrophage inflammatory proteins1A (MIP1A); granulocyte colony-stimulating factor (GCSF) thiab monocyte chemoattractant protein-1 (MCP1) qhia txog lub luag haujlwm ntawm cov mob hnyav heev thiab cytokine cua daj cua dub hauv cov kab mob kev loj hlob thiab hnyav [8]. Cov theem siab ntawm cov teeb meem kev sib haum xeeb tshwm sim los cuam tshuam nrograum- nyob hauv cov hlwb ua rau endothelial tsis ua haujlwm, microcirculatory derangement, thiab tubular raug mob [23].
3) Kev kis mob hnyav ntawm COVID-19 tshwm sim hauv lub xeev procoagulant nrog pom tseeb vascular tshwm sim ntawm SARS-CoV-2 induced coagulopathy li microvascular thrombosis, mob tubular thiab cortical necrosis nrog fibrinoid necrosis tom qab thiab glomerular ischemia thiab irreversibleraumkev puas tsuaj [24] SARS-CoV-2 kev kis kab mob pab txhawb kev tsim cov endothelins hauv ntau lub cev raws li qhov cuam tshuam ncaj qha ntawm tus kab mob cuam tshuam thiab tus tswv tsev inflammatory teb [25]. Qhov no muab qhov laj thawj rau kev kho mob kom ruaj khov ntawm endothelium thaum tiv thaiv kab mob sib kis, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas muaj cov kab mob endothelial ua tsis taus xws li ntshav qab zib, kub siab thiab rog [26].
4) Hauv cov neeg mob hnyav nrog ICU nyob ntev, lwm yam ua raumob raumsuav nrog hemodynamic instability, nephrotoxic tshuaj, mechanical ventilation thiab sepsis. Septic AKI hauv cov neeg mob zoo li no ua ke nrog lwm cov txheej txheem ntawmraum puas[27].
Mob lub raum sib thaminflammatory thiab tiv thaiv kab mob ntau dhau nrog cytokine overproduction yog koom nrog hauv lub ntsws-raumKev puas tsuaj bidirectional thiab ua lub luag haujlwm tseem ceeb hauv kev kis tus kab mob Fig. 1. Thaum kis tus kab mob COVID- 19, kev raug mob ntawm lub raum tubular epithelium txhawb nqa kev tswj hwm ntawm IL-6, tom qab ntawd ua rau siab dua alveolar-capillary permeability thiab pulmonary hemorrhage . Txawm li cas los xij, cov txheej txheem ntawm IL-6 raug mob rau lub ntsws epithelial thiab endothelial hlwb tseem yuav tsum tau piav qhia. Tsis tas li ntawd, ARDS tuaj yeem ua rau lub raum medullary hypoxia uas ua rau muaj kev thuam ntau dua rau tubular hlwb [27]. Kev sib cuam tshuam ntawm cov txheej txheem no muaj qhov cuam tshuam rau kev kho mob nrog rau kev tshem tawm ntawm lub cev ntawm cov cytokines.
Kev soj ntsuam qhov tshwm sim ntawm COVID-19 ntawm lub raum
Lub raumKev koom tes yog ib qho teeb meem loj ntawm kev kis tus kab mob COVID-19 thiab muaj kev pheej hmoo tseem ceeb ntawm kev tuag. COVID-19 cuam tshuam rau kev noj qab haus huv thiab muaj kab moblub raumtxuas ntxiv nthuav tawm.
Mob raum mob (AKI)Cov ntaub ntawv ntawm AKI hauv COVID-19 tau nce ntxiv nrog qhov sib txawv ntawm qhov teeb meem loj no. Qhov no zoo li nkag siab tau muab qhov nrawm nrawm ntawm kev sib kis, tshwj xeeb nrog kev cuam tshuam loj heev ntawm kev cuam tshuam ua pa qis thiab ua pa tsis ua haujlwm. AKI yog ib qho teeb meem uas feem ntau tshaj tawm ntawm COVID-19 uas tau txuas rau kev mob hnyav ntxiv thiab kev tuag. Tsis ntev los no, SARS-CoV-2 RNA raug kuaj pom hauvlub raumntawm 23 (72 feem pua) ntawm 32 tus neeg mob nrog AKI, piv rau qhov qis dua ntawm SARS-CoV-2 lub raum tropism hauv cov neeg mob uas tsis muaj AKI nrog tus kab mob RNA tsuas pom nyob rau hauv peb (43 feem pua) ntawm xya tus neeg mob [28]. Hauv pawg loj ntawm 1099 tus neeg mob nrog COVID-19, 93.6 feem pua tau mus pw hauv tsev kho mob, 91.1 feem pua tau mob ntsws, 5.3 feem pua tau mus rau ICU, 3.4 feem pua tau mob ua pa nyuaj (ARDS) tseem tsuas yog 0.5 feem pua muaj AKI [29]. Hauv lwm qhov xwm txheej ib leeg ntawm 138 tus neeg mob hauv tsev kho mob uas tau lees paub COVID{22}} mob ntsws nyob rau hauv Wuhan, Tuam Tshoj, AKI tau tshaj tawm txog 3.6 feem pua ntawm tag nrho cov neeg mob. Tsis xav tsis thoob thaum suav nrog cov txheej txheem ntawm kev kawm ICU tau txais cov neeg mob ICU, AKI tau nce mus rau 8.3 feem pua [7]. Ntxiv mus, cov kws tshawb fawb tau tshaj tawm txog kev sib koom ua ke ntawmmob raumthiab kev tuag hauv cov neeg mob hauv tsev kho mob. Ntau tshaj 40 feem pua muaj pov thawj ntawm qhov txawv txavlub raum ua haujlwmthiab 5.1 feem pua muaj AKI thaum lawv nyob hauv tsev kho mob. Qhov tshwm sim ntawm AKI tau nce siab dua hauv cov neeg mob uas nce qib hauv qab hauv cov ntshav creatinine (11.9 feem pua) piv rau cov neeg mob uas muaj cov txiaj ntsig zoo li qub (4.0 feem pua), Tsis tas li, proteinuria, hematuria, thiab AKI dhau theem 2 tau cuam tshuam nrog nce ntxiv. kev pheej hmoo ntawm kev tuag. Kev pheej hmoo ntau dhau ntawm kev tuag tsawg kawg yog 4 zaug tau tshaj tawm ntawm cov neeg uas muaj theem 3 AKI nrog rau lub luag haujlwm tseem ceeb ntawm lub ntsws-ob raum crosstalk [30].
Kev txheeb xyuas suav nrog tsib qhov kev tshawb fawb nrog rau tag nrho cov qauv loj ntawm 1415 COVID-19 cov neeg mob txhawm rau txheeb xyuas cov electrolytes hauv COVID-19 cov neeg mob uas muaj thiab tsis muaj daim ntawv hnyav tau lees paub tias COVID-19 qhov hnyav yog cuam tshuam nrog cov ntshav qab zib. Cov ntsiab lus ntawm sodium, potassium thiab calcium [31]. Tsis ntev los no, kev tshawb fawb txog kev tswj hwm hauv peb lub tsev kho mob hauv Fab Kis suav nrog 594 tus neeg laus thaum muaj xwm txheej ceev (ED) COVID-19 cov neeg mob uas tau sib npaug rau 594 tus neeg tsis yog-COVID-19 ED cov neeg mob (hnub nyoog thiab kev sib deev tswj) los ntawm Tib lub sijhawm tau pom tias hyponatremia thiab hypokalemia yog tus kheej cuam tshuam nrog COVID{11}} tus kab mob hauv cov neeg laus mus ntsib ED [32]. Electrolyte cuam tshuam tsis yog tsuas yog cuam tshuam rau kev kho mob ntawm kev tswj tus neeg mob, tab sis kuj tseem pab tshawb nrhiav cov txheej txheem kab mob hauv qab hauv COVID-19. Kev tso tawm ntau ntxiv ntawm cov tshuaj tiv thaiv diuretic hauv cov lus teb rau qhov ntim depletion xav tias yuav ua rau hyponatremia hauv COVID{14}} cov neeg mob. Raws li SARS-CoV-2 khi rau nws ACE2 tus tswv tsev receptor, nws txo ACE2 qhia, ua rau muaj zog tso zis ntau ntxiv hauv cov lus teb rau siab angiotensin II. Hypokalaemia ntxiv exacerbates ARDS thiab mob plawv raug mob, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob ntsws los yog lub plawv comorbidities [31,32]. Nyob rau hauv cov ntsiab lus no, nyob ze saib xyuas ntawmlub raum ua haujlwmthiab cov electrolytes hauv tsev kho mob COVID-19 cov neeg mob, tshwj xeeb yog cov neeg nyob hauv qhov chaw tseem ceeb, thiab siv cov cim rhiab AKI biomarkers xws li neutrophil gelatinase-associated lipocalin (NGAL) thiab/los yogmob raummolecule 1 (KIM-1) raug lees paub rau kev pheej hmoo-stratify cov neeg mob thiab ncaj qha cov peev txheej rau kev tiv thaiv lossis kev tshawb pom ntxov ntawm AKI thiab kev cuam tshuam raws sijhawm kom txo tau AKI kev nce qib thiab kev pheej hmoo tuag.
CISTANCHE yuav txhim kho lub raum / raum ua haujlwm
Kev lim ntshav thiab hloov pauv hauv lub sijhawm ntawm COVID-19Kev kho mob ntawm cov neeg mob dialysis thaum lub sij hawm tus kab mob COVID-19 muaj thoob qhov txhia chaw yog qhov nyuaj heev vim cov neeg mob muaj kev nyuaj siab lub cev tsis muaj zog cia nyob ib leeg txuam nrog comorbidities li ntshav qab zib thiab kab mob plawv. Ntau lub tswv yim los tswj kev lim ntshav thiab muab kev pab cuam lim ntshav rau cov neeg mob thaum lub sij hawm tus kab mob COVID{1}} tshwm sim no tau tsim. Hauv tsab ntawv tshaj tawm tsis ntev los no, cov kws sau ntawv tau qhia txog cov kev xav tseem ceeb hauv kev npaj cov kev pab cuam lim ntshav kom paub meej cov peev txheej txaus rau kev muab kev lim ntshav tsis cuam tshuam mus rau theem kawg.mob raumcov neeg mob, thaum txo qis kev pheej hmoo ntawm kev sib kis ntawm COVID-19 ntawm ib tus neeg mob, hauv zej zog thiab cov neeg ua haujlwm kho mob [33]. Cov lus pom zoo rau kev tiv thaiv thiab kev tswj hwm ntawm COVID-19 cov neeg mob hauv hemodialysis, peritoneal dialysis thiab kev kho lub raum tsis tu ncua (CRRT) hauv ICU tau tshaj tawm. Nws yog ib qho tsim nyog yuav tsum ua li ntawd hauv ntau txoj hauv kev los xyuas kom muaj kev nyab xeeb, zoo thiab tsis cuam tshuam kev lim ntshav thaum txo qis kev pheej hmoo kis mob [33,34].
Hauv tsab ntawv ceeb toom ntxov los ntawm Wuhan, Tuam Tshoj; Tus kab mob COVID-19 tau lees paub hauv 37 ntawm 230 tus neeg mob hemodialysis (16.1 feem pua) thiab 4 ntawm 33 tus neeg ua haujlwm (12.1 feem pua) tau kuaj pom tias muaj COVID-19. Nco ntsoov, cov neeg mob hemodialysis nrog COVID{10}} muaj lymphopenia tsawg dua, qis qis hauv cov ntshav cytokines, thiab cov kab mob me me dua li lwm cov neeg mob uas muaj tus kab mob COVID{11}} [35].Hloov raumCov neeg tau txais kev pab yuav tsum muaj kev tiv thaiv kev tiv thaiv kab mob mus ntev uas tsim los kom sib npaug ntawm kev ua tau zoo (tiv thaiv kev tsis lees paub) thiab kev nyab xeeb (txhim kev pheej hmoo kis tus kab mob) ntawm cov ntsiab lus sib txawv ntawm lub sijhawm tom qab hloov pauv. Ntawm 1073 tus neeg mob nrog COVID-19 thiabraum tsis ua haujlwmlos ntawm 26 lub teb chaws uas tau nkag mus hauv ERACODA, ERA-EDTA COVID-19 database, 21 feem pua ntawmraumCov neeg mob hloov pauv thiab 25 feem pua ntawm cov neeg mob lim ntshav tau tuag ntawm 28- hnub rov qab [36].
Thaum muaj tus kab mob kis thoob qhov txhia chaw, qhov kev txhawj xeeb tseem ceeb, yog li ntawd, kev tiv thaiv kev tiv thaiv kab mobraumallograft cov neeg tau txais txiaj ntsig ntau dua rau kev kis kab mob suav nrog COVID-19. Qhov kev sib kis no tsis yog cuam tshuam rau peb saib xyuas li casraum hloovcov neeg mob tab sis kuj muaj qhov cuam tshuam rau kev txwvraumtransplantation rau lifesaving tej yam kev mob thiab tso nyobhloov raumnyob qhov twg tus tuaghloov raumyog ua tau. Tsis tas li ntawd, nws yog ib qho kev ceeb toom kom tsis tu ncua lees paub qhov kev pheej hmoo ntawm kev kis kab mob tiv thaiv kab mob tsis yog hauv cov neeg mob hloov lub raum nkaus xwb tab sis kuj tseem nyob hauv lwm cov kab mob tiv thaiv kab mob nephrotic thiab cov neeg mob raum vasculitis. Thaum tsis muaj kev kho tshwj xeeb rau SARS-CoV-2 kab mob, feem ntau nephrology cov zej zog tau tshaj tawm cov lus pom zoo kom txo qis kev tiv thaiv kab mob rau qib uas pom tau tias muaj kev nyab xeeb, thaum lees paub tias ntsuas lawv qhov kev pheej hmoo piv rau cov txiaj ntsig tuaj yeem nyuaj [37]. Qhov teeb meem tseem ceeb thiab kev txwv tsis pub muaj peev xwm nyob rau hauv nruab nrab ntawm qhov tshwm sim no hu rau kev ua qauv kev kwv yees, kev npaj muaj xwm txheej ceev, thiab kev tswj hwm cov peev txheej kom ntsib kev hloov pauv ntawm COVID-19 kev sib kis [38].
Xaus
Tus kab mob coronavirus tshiab 2019 tau dhau los ua qhov teebmeem kev noj qab haus huv rau pej xeem phem tshaj plaws hauv ib puas xyoo uas nthuav tawm ntau yam kev sib tw tsis sib xws rau cov kab ke kev noj qab haus huv thoob ntiaj teb. Raws li COVID-19 cuam tshuam raulub raumua kom hloov zuj zus mus, nephrologists tau dhau los ua qhov kev ceeb toom siab nrog cov ntaub ntawv tshaj tawm ntawmraumkev koom tes. Tsis tas li ntawd, tus kab mob kis thoob qhov txhia chaw tau ua rau nws mob ntevmob raumCov neeg mob cuam tshuam rau lawv cov kev tswj xyuas kev saib xyuas kev noj qab haus huv, tab sis cov kev kho mob ntse yuav tsum tau tso siab ntxiv. Cov lus pom zoo uas tau tshaj tawm tsis ntev los no yog qhov muaj txiaj ntsig zoo los daws qhov cuam tshuam tsis zoo ntawm tus kab mob COVID-19 ntawm cov neeg mob lim ntshav thiab hloov pauv cov neeg mob. Qhov tau hais tias, qhov cuam tshuam tag nrho ntawm COVID-19 kev kis tus kab mob mus ntevmob raumcov neeg mob tseem yuav elucidated. Cov tswv yim nthuav dav suav nrog cov phiaj xwm xwm txheej ceev, kev tswj hwm cov peev txheej thiab kev ntsuas kev tiv thaiv kab mob yuav tsum tau tsim thiab hloov kho tsis tu ncua hauv kev lim ntshav thiab hloov pauv. Ntxiv mus, nyob ze saib xyuas ntawmlub raum ua haujlwmthiab kuaj cov zis ntxov rau cov urinary sediment nrog rau cov zis biomarkers hauv COVID-19 cov neeg mob tau pom zoo kom ua kom zoo rau kev kuaj mob ntxov thiab kev pabcuam kho mob raws sijhawm. Kev hloov kho tshiab tsis tu ncua ntawm kev tiv thaiv, kev kuaj mob thiab cov tswv yim kho mob yog qhov tseem ceeb los txhim kho cov txiaj ntsig kho mob thiab txo qis kev pheej hmoo mob / tuag ntau dua.
