Introduction
The pandemic has been a frequently used medical term for our world in
the last year and whose meaning is known to everyone. Although pandemics
have not left our world since the existence of humanity, the
sociocultural, economic and psychological effects they create leave
lasting damage to people. Covid-19 is the latest pandemic that our world
has experienced, and while most affected people are prevalent with mild
symptoms such as loss of taste and smell, sore throat, joint pain and
headache, especially in individuals over 65 who have comorbidity, it can
progress with morbidity and mortality comorbidity 1.
Acute respiratory failure syndrome has been one of the most important
causes of mortality since the beginning of Covid-19 infection. With
increased experience in patients, more frequent observance of thrombotic
events and renal failure compared to known viral infections in followed
patients has resulted in deepening of research 2, 3.
Initially, the angiotensin-converting enzyme 2 (ACE2) receptor was
considered the most important receptor in the introduction of the virus
into the cell and medical treatments were moving in this direction.
However, later the discovery of the transmembrane protein serine
protease-2 (TMPRSS2), which facilitates the introduction of the virus
into the cell, and kidney injury molecule-1 (KIM-1), which is highly
synthesized especially in the lung, and kidney, has caused the direction
of treatment and target to change 4, 5.
The KIM-1 molecule, which was previously associated with acute kidney
damage, is synthesized in proximal tubules after kidney damage and plays
an important role in inflammation and immune response. Research has
shown that the KIM-1 molecule, which is significantly synthesized in the
lung and kidney, can be a receptor that facilitates the binding of
SARS-CoV-2 to the cell surface through the IgV field and have put
forward that it may be the cause of acute kidney damage in patients with
Covid-19 5, 6 . Soluble urokinase plasminogen activator (suPAR), the
dissolved form of urokinase plasminogen activator, has been another
molecule thought to be responsible for acute kidney damage that may
develop in Covid-19 7. However, suPAR may also play a role in fetal
complications that may occur in the lungs and heart 8. suPAR plays an
important role in the remodeling of tissues under inflammation and
immune cell migration and activation. It also balances tissue and organ
damage that may develop due to excessive inflammatory response 9.
Therefore, its importance increases even more, especially in a disease
such as Covid-19, where the abnormal inflammatory response is involved.
In our study, we aimed to investigate the role of serum suPAR and KIM-1
level in determining the relationship with clinical course in Covid-19
patients who did not develop acute renal failure in their follow-up.