key: cord-0869830-rvb7b3f1
authors: Nematbakhsh, Mehdi
title: Gender related of acute kidney injury in COVID-19 patients
date: 2021-08-30
journal: J Res Med Sci
DOI: 10.4103/jrms.jrms_1034_20
sha: 7fa3a85c8ce68861b685ab66ddd7438e3d1a7c33
doc_id: 869830
cord_uid: rvb7b3f1

nan

Dear Editor, The coronavirus disease 2019 (COVID-19) is well recognized as a global pandemic worldwide. Besides the significant prevalence of pneumonia and acute respiratory distress syndrome (ARDS), acute or chronic kidney diseases are subject of debate in patients with COVID-19. The 0.5%, 4.3%, 4.5%, 7%, 10.5%, 23%, or 34.6% prevalence of acute or chronic kidney diseases among the patients with COVID-19 were reported. [1] [2] [3] [4] [5] The major cause of acute kidney injury (AKI) was related to cytokine damage or organ cross-talk between the pulmonary and renal system and cardio-renal syndrome in COVID-19 patients. [1] Abnormal urine dipstick test or AKI were also detected in 75.4% of 333 patients with COVID-19. [3] The kidney histopathological investigation in 26 patients with COVID-19 showed the existence of proximal tubule injury with loss of brush border. [5] It seems that the cytokine storm induced tubular injury, cytopathic effect of virus, angiotensin-converting enzyme-2 (ACE2) expression effect on podocytes and tubular epithelial cell or viral tropism are the main important factors in the pathophysiology of AKI associated with COVID-19. [6] Generally, there is an association between ARDS and AKI, and the prevalence of AKI compared to ARDS is low. However, the occurrence of AKI in ARDS patients with COVID-19 must be monitored seriously for hospitalized patients to reduce the mortality rate during the COVID-19 crisis. In addition, the use of ACE inhibitors or angiotensin-receptor blockers may worse infection in COVID-19 patients, and the control of ACE2 is suggested. Now, one question needs to be considered here. Does AKI in patient with COVID-19 occurs gender dependently or not? It is documented that cytokine storm is gender related, [7] and a higher ACE2 expression [8] was detected in old female rats than male and it contributes in SARS attacks. Increased ACE2 activity in male animals compare to females also is existed. [9] Although the existence of an equal prevalence of COVID-19 between males and females, however, the mortality rate in males is higher than females. [10] The activity of renin-angiotensin system (RAS) is gender related,

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