KidneyIntelX in Multi-Center Study to Monitor and Predict Kidney Risk in COVID-19 Patients - Seite 2

“With the pandemic spread of COVID-19 and the increased morbidity and mortality from COVID-19 in patients with diabetes, CKD and acute kidney injury, it is imperative to define the underlying mechanisms of COVID-associated kidney disease and develop solutions to guide patient care,” said F. Perry Wilson, M.D., MSCE, MASKeD-COVID Principal Investigator, Yale School of Medicine. “This can be best achieved through collaboration in all aspects including data sharing, biomarker analysis, data analytics and clinical translation. RenalytixAI and Mount Sinai have assembled an outstanding team to address critical issues regarding COVID-19 and kidney disease.”

“This collaborative approach is vital for us to further develop some important findings by the respective groups to date,” said Matthias Kretzler, M.D., MASKeD-COVID Principal Investigator at University of Michigan. “We have demonstrated that ACE2 (the SARS-CoV-2 receptor) is co-expressed with a set of genes in the proximal tubules also having functions in viral entry, establishment of viral replication, and innate immunity.² We look forward to working with this outstanding team to further expand on this research and further define the underlying mechanisms of COVID-associated kidney disease.”

SARS-CoV-2 is believed to result in acute kidney injury through multiple mechanisms, including severe inflammation, endothelial damage, microthrombi, and possibly direct invasion of the virus into kidney epithelial cells.³ The burden and incidence of post-COVID-19 CKD and end-stage kidney disease (ESKD) is currently unknown, given the recency of the pandemic. However, emerging evidence suggests patients surviving COVID-19 will experience a significant increased risk of kidney disease, including the following:

• Approximately 20% to 45% of patients hospitalized with COVID-19 in the United States and over 60% of patients admitted to the ICU for COVID-19 in the United States experience acute kidney injury (AKI), approximately 25% to 45% of whom require acute dialysis;⁴ 
• Data from an analysis of over 3,000 patients admitted to Mount Sinai indicates that 50% of surviving patients who experienced AKI during hospitalization for COVID-19 had persistently abnormal kidney function at the time of discharge;⁵
• It has been established in the literature that AKI is strongly associated with development of CKD, CKD progression, and ESKD;⁶
• Given the observed severity of kidney injury in many COVID-19 patients, both clinically and histopathologically, the risk for subsequent transition to CKD and ESKD is likely to be high in survivors.⁷

“There are so many questions yet to be answered regarding COVID-19 and kidney disease. For example, we don’t yet know the risk factor and mediators of AKI to CKD transition after COVID-19. We also don’t know the predictors of long-term outcomes after COVID-19,” said Evren Azeloglu, Ph.D., Assistant Professor of Nephrology and Pharmacological Sciences at the Icahn School of Medicine at Mount Sinai. “Moreover, we need to understand how this “second hit” from COVID-19 interacts with other risk factors such as underlying APOL1 genotypes to heighten the potential for proteinuric nephropathy. Additional work with biomarker research, kidney tissue histopathology, and gene expression signatures is needed to understand the disease and the long-term implications.”