COVID-19 and Kidney Disease: Molecular Determinants and Clinical Implications in Renal Cancer

Eur Urol Focus. 2020 Sep 15;6(5):1086-1096. doi: 10.1016/j.euf.2020.06.002. Epub 2020 Jun 9.

Abstract

Context: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic that erupted in December 2019 has affected more than a million people from over 200 countries, claiming over 70 000 lives (by April 7, 2020). As the viral infection is driven by increased angiotensin-converting enzyme-2 (ACE2) expression, with the kidney exhibiting the highest expression, it is crucial to gain insights into the mechanisms underlying renal cell carcinoma (RCC) and coronavirus disease 2019 (COVID-19).

Objective: This study considers up-to-date information on the biological determinants shared by COVID-19 and renal disease, and aims to provide evidence-based recommendations for the clinical management of RCC patients with COVID-19.

Evidence acquisition: A literature search was performed using all sources (MEDLINE, EMBASE, ScienceDirect, Cochrane Libraries, and Web of Science). As of March 31, 2020, the Center for Disease Control reported that of the adults hospitalized for COVID-19 with underlying conditions in the USA, 74.8% had chronic renal disease.

Evidence synthesis: Evidence is discussed from epidemiological studies on SARS-CoV-2 pandemic and molecular studies on the role of kidney in facilitating routes for SARS-CoV-2 entry, leading to increased virulence of SARS-CoV-2 and clinical manifestation of symptoms in RCC.

Conclusions: This analysis will advance our understanding of (1) the molecular signatures shared by RCC and COVID-19 and (2) the clinical implications of overlapping signaling pathways in the therapeutic management of RCC and COVID-19 patients.

Patient summary: Amid the coronavirus disease 2019 (COVID-19) pandemic, patients diagnosed with renal cell carcinoma and infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may receive complimentary treatment modalities to enhance therapeutic response.

Keywords: Renal tumors; Therapeutic targeting; Viral infection.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / epidemiology
  • Acute Kidney Injury / metabolism
  • Acute Kidney Injury / therapy
  • Angiotensin-Converting Enzyme 2
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antibodies, Neutralizing / therapeutic use
  • Antineoplastic Agents, Immunological / therapeutic use
  • Antiviral Agents / therapeutic use
  • Betacoronavirus / metabolism*
  • COVID-19
  • COVID-19 Drug Treatment
  • Carcinoma, Renal Cell / epidemiology
  • Carcinoma, Renal Cell / metabolism*
  • Comorbidity
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / metabolism*
  • Coronavirus Infections / physiopathology
  • Endothelin Receptor Antagonists / therapeutic use
  • Hospitalization
  • Humans
  • Ipilimumab / therapeutic use
  • Kidney Neoplasms / drug therapy
  • Kidney Neoplasms / epidemiology
  • Kidney Neoplasms / metabolism*
  • Liquid Biopsy
  • Nivolumab / therapeutic use
  • Pandemics
  • Peptidyl-Dipeptidase A / metabolism*
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / metabolism*
  • Pneumonia, Viral / physiopathology
  • Protein Kinase Inhibitors / therapeutic use
  • Renal Dialysis
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / metabolism*
  • Renal Insufficiency, Chronic / therapy
  • SARS-CoV-2
  • Serine Endopeptidases / metabolism
  • Severity of Illness Index
  • Spike Glycoprotein, Coronavirus / metabolism*
  • Sunitinib / therapeutic use

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Antibodies, Neutralizing
  • Antineoplastic Agents, Immunological
  • Antiviral Agents
  • Endothelin Receptor Antagonists
  • Ipilimumab
  • Protein Kinase Inhibitors
  • Spike Glycoprotein, Coronavirus
  • spike protein, SARS-CoV-2
  • Nivolumab
  • Peptidyl-Dipeptidase A
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2
  • Serine Endopeptidases
  • TMPRSS2 protein, human
  • Sunitinib