由 SARS-CoV-2 引起的新型冠状病毒感染对儿童肾脏的损害:系统综述

E.P. Bataeva, I. K. Bogomolova, A. Dolina, A.G. Oparina
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摘要

本文献综述基于 2020 年 3 月至 2022 年 12 月期间发表在 PubMed Central® (PMC) 数据库中的研究,使用的关键词如下:"SARS-CoV-2"、"COVID-19 "和 "儿童":"SARS-CoV-2"、"COVID-19"、"肾损伤 "和 "儿童"。分析了与儿童感染 SARS-CoV-2(严重急性呼吸系统综合征冠状病毒)相关的肾损伤的临床标准、实验室症状、可能的致病反应途径和预期长期结果等信息。研究人员试图根据以往的肾脏病理情况,追踪新冠状病毒感染的表现特征。SARS-CoV-2病毒对肾素-血管紧张素-醛固酮系统(RAAS)的直接影响、缺血、高凝、细胞因子风暴、横纹肌溶解、肺-肾致病反应等导致肾组织病变的多病因性质显而易见。研究发现,在儿童群体中,严重的 COVID-19 肾损伤在儿童多系统炎症综合征(MIS)患者入住重症监护室(ICU)时更为常见。表现形式从轻微的泌尿系统综合征到急性肾损伤(AKI)。本文描述了儿童感染冠状病毒后某些疾病的后果和病程,以及既往有肾脏病变的患者感染冠状病毒的临床和实验室特征。研究结果表明,有必要对患有或未患有肾功能不全的 COVID-19 儿童进行长期随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
KIDNEY DAMAGE IN CHILDREN WITH A NEW CORONAVIRUS INFECTION CAUSED BY SARS-CoV-2: A SYSTEMATIC REVIEW
This bibliographical review is based on studies published in the PubMed Central® (PMC) database between Mar. 2020 and Dec. 2022 using the keywords as follows: “SARS-CoV-2,” “COVID-19,” “kidney damage” and “children.” Information on clinical criteria, laboratory symptoms, possible pathogenetic response pathways and expected long-term outcomes of kidney damage associated with SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus) infection in children was analyzed. An attempt was made to trace the features of manifestations of the new coronavirus infection depending on previous renal pathology. The polyetiological nature of renal tissue lesion is evident, which is the result of direct effect of SARS-CoV-2 virus on the renin-angiotensin-aldosterone system (RAAS), ischemia, hypercoagulation, cytokine storm, rhabdomyolysis, pulmonary-renal pathogenic reaction etc. Kidney damage in the pediatric population has been found to be more frequent in the severe COVID-19 in children with multisystem inflammatory syndrome (MIS) in the setting of admission at the intensive care unit (ICU). Manifestations range from minor urinary syndrome to the development of acute kidney injury (AKI). A number of consequences and cases of the course of some diseases after coronavirus infection in children as well as clinical and laboratory features of coronavirus infection in patients with previous renal pathology are described. The findings initiated the need for the long-term follow-up of children with COVID-19 both with and without renal insufficiency.
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