Abstract Background Acute kidney injury (AKI) occurs among patients with coronavirus disease-19 (COVID-19) and has also been indicated to be associated with in-hospital mortality. Remdesivir has been authorized for the treatment of COVID-19. We conducted a systematic review to evaluate the incidence of AKI in hospitalized COVID-19 patients. The incidence of AKI in different subgroups was also investigated. Methods A thorough search was performed to find relevant studies in PubMed, Web of Science, medRxiv and EMBASE from 1 Jan 2020 until 1 June 2020. The systematic review was performed using the meta package in R (4.0.1). Results A total of 16,199 COVID-19 patients were included in our systematic review. The pooled estimated incidence of AKI in all hospitalized COVID-19 patients was 10.0% (95% CI: 7.0–12.0%). The pooled estimated proportion of COVID-19 patients who needed continuous renal replacement therapy (CRRT) was 4% (95% CI: 3–6%). According to our subgroup analysis, the incidence of AKI could be associated with age, disease severity and ethnicity. The incidence of AKI in hospitalized COVID-19 patients being treated with remdesivir was 7% (95% CI: 3–13%) in a total of 5 studies. Conclusion We found that AKI was not rare in hospitalized COVID-19 patients. The incidence of AKI could be associated with age, disease severity and ethnicity. Remdesivir probably did not induce AKI in COVID-19 patients. Our systematic review provides evidence that AKI might be closely associated with SARS-CoV-2 infection, which should be investigated in future studies.
Abstract Some triple-negative breast cancer (TNBC) patients evaluated as Miller-Payne 4 with ypN0 after neoadjuvant chemotherapy (NACT) who have better prognoses should avoid escalation of therapy. We aim to identify these patients by evaluating pretherapeutic spatial distributions of immunophenotypes. Our retrospective study in patients with TNBC assessed as Miller-Payne grade 4/5 with ypN0 showed that Miller-Payne 4 with ypN0 group had poorer 5-year disease-free survival (DFS, 63.8% vs. 83.0%, p = 0.003) and the 5-year overall survival (OS, 71.0% vs. 85.5% , p = 0.007) than Miller-Payne 5 with ypN0 group. High TILs were significantly associated with better DFS and OS in patients with Miller-Payne 4 and ypN0 (both p = 0.016). Spatially, detected by multiplexed ion beam imaging by the time of flight combined with proteomics, tumors assessed as Miller-Payne 4 and ypN0 with good prognosis exhibited an inflamed phenotype, with dominant CD8+ T cells on tumor center, few scattered CD68+ myeloid-derived cells far away from T cells, and deposit of increased activated molecules of lymphocyte. While those with poor prognoses presented excluded phenotypes, with few CD8+ T cells restricted to invasive margins and a high density of CD14 + CD68 + CD11c + myeloid cells. A good classifier model based on 29 spatial immunophenotypes was established by the random forest algorithm (AUC = 0.975), for identifying patients with Miller-Payne 4 and ypN0 who had favorable prognoses. We also observed similar signatures in patients with Miller-Payne 5 and ypN0. Taken together, spatial immunophenotypes may assess the prognosis in TNBC patients with Miller-Payne 4 and ypN0 after NACT.
OBJECTIVE To explore the correlation of chemokines and chemokine receptors with clinical features of newly diagnosed systemic lupus erythematosus (SLE). METHODS Samples of venous blood were collected from 37 newly diagnosed SLE patients, 2 males and 35 females, aged 32.5 (15-54), and 20 healthy controls. The serum concentration of macrophage inflammatory protein-1alpha (MIP-1alpha), MIP-1beta and reduced upon activation normal T cell expressed and secreted (RANTES) were measured by ELISA. Samples of anticoagulative serum were collected from 18 of the 37 newly diagnosed SLE patients and 10 healthy controls. The expression rates of CCR1, CCR3, and CCR5 on CD4+ T cells were detected by flow cytometry. Indirect immunofluorescence method was used to detect the anti-ds-DNA antibody, and blot immunoassay was used to detect the anti-RNP and anti-SSA antibodies. The associations of chemokines and chemokine receptors with the clinical features were analyzed. RESULTS The serum concentration of MIP-1alpha of the SLE patients was (37 +/- 25) ng/L, significantly higher than that of the controls (8 +/- 9) ng/L (P 0.05). The serum concentration of MIP-1alpha of the SLE patients with fever was 52 ng/L +/- 27 ng/L, significantly higher than that of the SLE patients without fever (28 ng/L +/- 19 ng/L, P = 0.006). The serum concentration of MIP-1beta of the SLE patients with arthritis was 221 ng/L +/- 158 ng/L, significantly higher than that of the SLE patients without arthritis (95 ng/L +/- 83 ng/L, P = 0.008). The serum concentration of RANTES of the SLE patients with low blood platelet count was 130 ng/L +/- 122 ng/L, significantly lower than that of the SLE patients with normal blood platelet count (212 ng/L +/- 114 ng/L, P = 0.049). The percentage of CD4+ CCR3+ T cell subgroup in CD4+ T cell in peripheral blood of the SLE patients positive in anti-RNP antibody was 14.8% +/- 3.0%, significantly lower than that of the SLE patients negative in anti-RNP antibody (11.3% +/- 2.6%, P = 0.018). CONCLUSION Abnormality of different chemokines and chemokine receptors may concern with different clinical features of SLE.