Acute Kidney Dysfunction in COVID-19 and Non-COVID-19 Related ARDS

Study Overview
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Brief Summary
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In addition to respiratory involvement, SARS-CoV 2, the virus responsible for coronavirus 2019 or Covid-19, appears to be responsible for renal involvement such as acute renal failure or proteinuria, so the mechanisms are not known at this time. The consequences of Covid-19 on renal function in the short and long term are not known. It is important to be able to better document these renal impairments to understand the mechanisms of this disease. The main objective of this study is to describe the prevalence of Covid-19-related renal damage (acute renal failure, proteinuria, microalbuminuria, hematuria) in a large cohort of patients in intensive care for SARS-CoV 2 infection with severe respiratory impairment. The other objectives will be to evaluate in this cohort the impact of these renal impairments on the severity of the Covid-19 disease, and to compare them to the renal impairments of patients in intensive care for acute respiratory distress syndrome (ARDS) due to other respiratory diseases. Blood and urine samples will be taken at the time of intubation in all critically ill patients with respiratory distress requiring mechanical ventilation for Covid-19 or other cause of respiratory distress with PaO2/FiO2 ratio < 300. Patients will be followed for the duration of their ICU and hospital stay. Data will be collected prospectively in three ICUs in the University Hospitals of Marseille.

Official Title
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Prevalence of COVID-19-associated Kidney Injury in ICU and Prognosis of Proximal Tubular Injury in ARDS: the URICOV Study

Conditions
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COVID-19 Acute Respiratory Distress Syndrome, Acute Kidney Injury Due to COVID-19

Intervention / Treatment
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* Other: Data collection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • Displaying acute respiratory distress Needing invasive mechanical ventilation With PaO2/FiO2 ratio < 300 after orotracheal intubation Exclusion Criteria: Patients in ICU following thoracic surgery or lung transplantation Patients with cardiogenic pulmonary oedema Patients with end stage kidney disease Moribund patients

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients in intensive care for SARS-CoV 2 infection with severe respiratory impairment.<br> | Other: Data collection<br>* acute kidney injury and tubular dysfunction<br>|
| Patients in intensive care without SARS-CoV 2 infection with severe respiratory impairment.<br> | Other: Data collection<br>* acute kidney injury and tubular dysfunction<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluation of the incidence of acute kidney injury and tubular dysfunction | We aimed to perform a detailed analysis of urinary markers of kidney dysfunction with urine protein electrophoresis and tubular protein dosage in a prospective cohort of critically ill patients in ICU for ARDS due to COVID-19 in the first 24 hours following orotracheal intubation, to evaluate the incidence of acute kidney injury (AKI) and tubular dysfunction among critically ill patients with COVID-19-related ARDS at the onset of Mechanical ventilation, and to specify which part of the kidney parenchyma is involved. | First 24 hours after orotracheal intubation |