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.