Evaluation of Kidney Function in Patients with COVID-19 at the Epidemiological Treatment Centre in CHNU Fann

Alteration of renal function during SARS-CoV-2 infection is frequent and is associated with excess mortality. It is multifactorial, involving mechanisms more specific to COVID-19: viral invasion, endothelitis and thrombosis, activation of the renin-angiotensin-aldosterone system, and elevation of pro-inflammatory cytokines. Thus, the objective of this work was to assess renal function in patients with moderate and severe forms of COVID-19. This was a prospective cross-sectional study of patients with COVID-19. The parameters studied were age, sex, uremia, creatinine and glomerular filtration rate (GFR). All biological parameters were measured with the A15 Biosystems automated system (Barcelona, Spain) and the GFR was calculated according to the MDRD formula. Data processing was carried out with the SPSS (Statistical Package for Social Sciences) software version 23. Our study population consisted of 192 subjects with COVID-19, of which 111 were moderate and 81 were severe. The mean age of our subjects was 60 years and a sex ratio of 1.02. GFR assessment showed that 28% of the population had a lowered GFR (<60 mL/min/1.73m2). Analysis of the results according to the clinical forms showed frequencies of 19% of disturbance of renal function for the moderate forms against 40% for the severe forms. Impaired renal function appears to be frequent in patients with severe SARS-CoV-2 infection and is associated with a bad prognosis. Any patient hospitalized with SARS-CoV-2 should benefit from an initial nephrological assessment which could be used as a marker to dictate the prognosis of the severity of COVID-19.

Association between Hyperhomocysteinemia and Microangiopathic Complications (Neuropathy and Nephropathy) in Subjects with Type 1 and Type 2 Diabetes

This prospective case-control study aimed to assess the prevalence of hyperhomocysteinemia and explore its potential correlation with microangiopathic complications, specifically nephropathy and neuropathy, in a cohort of both type 1 and type 2 diabetic patients. Conducted at the Marc Sankalé Center of Abass Ndao Hospital in Dakar from June to September 2018, the study enrolled a total of 106 diabetic patients, comprising 93 type 2 diabetics and 13 type 1 diabetics, who were matched with control subjects free from clinically detectable pathologies, based on sex and age ± 2 years. The mean age of type 1 and type 2 diabetic patients was 24.46 ± 8.41 years and 57.28 ± 11.28 years, respectively. Our findings revealed a statistically significant elevation in mean homocysteine levels among patients when compared to controls (12.63 vs. 9.88;p < 0.0001). Hyperhomocysteinemia was observed in 24.5% of the patients, exclusively among those with type 2 diabetes. Within the hyperhomocysteinemia subgroup, 58% were male, and 42% were female. The analysis of neuropathy and nephropathy frequencies among type 2 diabetic patients, stratified by homocysteine concentrations, demonstrated a notably higher prevalence of diabetic nephropathy in patients with hyperhomocysteinemia compared to those with normohomocysteinemia (23.07% vs. 8.75%;p = 0.052). Similarly, diabetic neuropathy exhibited a significantly greater frequency in patients with hyperhomocysteinemia as opposed to normohomocysteinemia (80.76% vs. 50%;p = 0.005). Furthermore, our results established a significant positive correlation between homocysteine concentrations and both age (r = 0.402;p < 0.0001) and creatinine levels (r = 0.461;p < 0.0001). Bivariate logistic regression analysis indicated that patients with hyperhomocysteinemia faced 3 times and 6 times higher risks of developing neuropathy (OR = 3.5;p = 0.061) and diabetic nephropathy (OR = 6.092;p = 0.014), respectively.

Association between Uric Acid and Metabolic Syndrome in Homozygous Sickle Cell Patients

The objective of this study was to assess the association between uric acid and the metabolic syndrome and its components in homozygous sickle cell patients. This is a prospective case/control study of sickle cell SS patients. Each patient was matched to a control of the same sex and age ± 2 years. In our framework, we used the criteria for defining metabolic syndrome according to International Diabetes Federation (IDF) 2009. Assay of all biological parameters was performed with the ARCHITECT ci4100, Abbot (Chicago, Illinois, USA). Data were collected with Excel 2016 software and statistical analysis was done using XLSTAT 2019 software. Student’s T test was used to compare means and a p-value less than 0.05 was considered significant. The study population consisted of 100 homozygous sickle cell patients with an average age of 26 years with a sex ratio of 0.58. The prevalence of metabolic syndrome in our population according to the IDF 2009 was 2%. In our study 28% of patients presented with hyperuricemia. Uricaemia was significantly elevated in patients with components of the metabolic syndrome, in particular in 33% of patients with a large waist circumference, in 25% of hypertensive patients, in 50% of patients with hypertriglyceridemia and in 60% of patients with hypertriglyceridemia and low HDL-cholesterol levels. Significant correlations were found between uricemia and certain components of the metabolic syndrome, in particular the level of triglycerides (r = 0.31, p = 0.002), blood sugar (r = 0.16;p = 0.012), around size (r = 0.071;p ≤ 0.05), HDL-Cholesterol (r = ﹣0.01;p = 0.018), PAS (r = 0.076;p = 0.035) and PAD (r = ﹣0.18;p = 0.0015).