Adrian Covic

Adrian Covic
Universitatea de Medicina si Farmacie Grigore T. Popa Iasi | UMF Iasi · Department of Internal Medicine (Nephrology)

MD, PhD, FRCP, FERA, FESC, Prof.

About

823
Publications
172,976
Reads
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22,003
Citations
Citations since 2016
313 Research Items
13220 Citations
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Introduction
Interested in improving survival of the renal patients through a better understanding of the various "killer" pathways: anemia, CKD-MBD, vascular damage, (over)hydration. Interested in improving the Romanian scientific climate. Deep passion for clinical research and fostering the best conditions for developing researcher skills in young collaborators.
Additional affiliations
March 1999 - February 2000
MetroHealth Medical Center
Position
  • Research Director
March 1999 - February 2000
Case Western Reserve University School of Medicine
Position
  • Research Assistant
January 1999 - March 2000
Case Western Reserve University
Position
  • Principal Investigator

Publications

Publications (823)
Article
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Background Endothelial dysfunction is associated with elevated cardiovascular risk in patients with end-stage renal disease (ESRD). Kidney transplantation has demonstrated significant ability in reducing mortality and improving quality of life in recipients. Recent studies have also reported improvements in endothelial function following kidney tra...
Article
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Owing to the vulnerability of patients with chronic kidney disease to infectious diseases, the coronavirus disease 2019 (COVID-19) pandemic has been particularly devastating for the nephrology community. Unfortunately, the possibility of future COVID-19 waves or outbreaks of other infectious diseases with pandemic potential cannot be ruled out. The...
Article
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Background Hemodynamic instability in patients undergoing kidney replacement therapy (KRT) is one of the most common and essential factors influencing mortality, morbidity, and the quality of life in this patient population. Method Decreased cardiac preload, reduced systemic vascular resistance, redistribution of fluids, fluid overload, inflammato...
Article
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In the general population with COVID-19, the male sex is an established risk factor for mortality, in part due to a more robust immune response to COVID-19 in women. Because patients on kidney function replacement therapy (KFRT) have an impaired immune response, especially kidney transplant recipients due to their use of immunosuppressants, we exam...
Article
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Background Immunotherapy with immune checkpoint inhibitors (ICPi) may cause acute kidney injury (AKI) and their use is increasing. Materials and methodsThis is a single-center retrospective cohort study of patients receiving ICPi drugs for solid organ malignancies. ICPi-related AKI, the need for renal replacement therapy during or following ICPi tr...
Article
Introduction Myocardial fibrosis represents a landmark characteristic of uremic cardiomyopathy, leading to a high burden of arrhythmias, diastolic dysfunction (DD) and ultimately heart failure in this population. Collagen-derived biomarkers (Procollagen type I carboxy-terminal propeptide (PICP), Procollagen type III N-terminal peptide (P3NP)) and G...
Article
Introduction In chronic kidney disease (CKD) patients, the case fatality rate caused by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is higher than in the general population [1]. In patients hospitalised with COVID 19, right heart dysfunction is present in 20% of the cases, associated with an increased risk of all-cause death [...
Article
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Chronic kidney disease (CKD) will become the 5th global case of death by 2040. Its largest impact is on premature mortality but the number of persons with kidney failure require kidney replacement therapy (KRT) is also increasing dramatically. Current KRT is suboptimal due to the shortage of kidney donors and dismal outcomes associated with both he...
Article
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Background Several guidelines recommend using the Clinical Frailty Scale (CFS) for triage of critically ill COVID-19 patients. This study evaluates the impact of CFS on intensive care unit (ICU) admission rate, and hospital- and ICU mortality rates in hospitalized dialysis patients with COVID-19. Methods We analysed data of dialysis patients diagn...
Article
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Background: Accurately selecting hypertensive candidates for renal denervation (RDN) therapy is required, as one-third of patients who undergo RDN are non-responders. We aimed to systematically review the literature on RDN response prediction using arterial stiffness assessment, optimizing the selection of patients referred for interventional bloo...
Article
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Background Risk assessment tools for predicting mortality and end-stage renal disease (ESRD) in the elderly with CKD have received growing attention. However, integrating risk equations into a multidimensional approach of elderly with CKD stage 3b-4 is lacking. Methods In this prospective observational study, we enrolled CKD stage 3b-4 patients ag...
Article
Acute kidney injury (AKI) is defined by a rapid increase in serum creatinine levels, reduced urine output, or both. Death may occur in 16%-49% of patients admitted to an intensive care unit with severe AKI. Complex arrhythmias are a potentially serious complication in AKI patients with pre-existing or AKI-induced heart damage and myocardial dysfunc...
Article
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Background: Heart rate variability (HRV) could have independent and critical prognostic values in patients admitted for ST segment elevation myocardial infarction (STEMI). There are limited data in the literature regarding HRV assessment in STEMI setting. Thus, we aim to investigate the potential correlations between HRV and adverse outcomes in a...
Article
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Background The coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) produced a pandemic since March 2020 by affecting more than 243 million people with more than 5 million deaths globally. SARS-CoV-2 infection is produced by binding to angiotensin-converting enzyme, which among other sites is hig...
Article
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Background Acute kidney injury (AKI) in COVID-19 patients is associated with poor prognosis. However, the incidence, risk factors and potential outcomes of AKI in hospitalized patients are not well studied.Materials and methods This is a retrospective cohort study conducted in two major university hospitals. Electronic health records of the patient...
Article
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Background Sodium–glucose cotransporter 2 inhibitors (SGLT2i) improve outcomes of patients with type 2 diabetes at high cardiovascular risk and chronic kidney disease. Recent studies showed an increase in hemoglobin and hematocrit after SGLT2i treatment.Materials and methodsWe did a systematic review and meta-analysis of randomized, double-blind, p...
Article
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Pulmonary arterial hypertension (PH) has a high prevalence in chronic kidney disease (CKD) patients, especially those undergoing kidney transplantation (KT). We aimed to systematically review and calculate the pooled effect size of the literature evaluating the association between pre-existing PH documented by transthoracic echocardiography (TTE) o...
Article
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Background In the general population with COVID-19, obesity is associated with an increased risk of mortality. Given the typically observed obesity paradox among patients on kidney function replacement therapy (KFRT), especially dialysis patients, we examined the association of obesity with mortality among dialysis patients or living with a kidney...
Article
Background: Kidney transplant patients are at high risk for coronavirus disease 2019 (COVID-19)-related mortality. However, limited data are available on longer-term clinical, functional, and mental health outcomes in patients who survive COVID-19. Methods: We analyzed data from adult kidney transplant patients in the European Renal Association...
Article
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Background Recent studies show that obese patients have worse outcomes in IgA nephropathy as compared to normal weight patients. Materials and methods We performed a systematic review and meta-analysis of prospective, retrospective, randomized and nonrandomized studies, which studied the impact of obesity or high body mass index (BMI) on different...
Article
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Purpose The aim of this prospective cohort study was: to identify the association between different biomarkers [proprotein convertase subtilisin/kexin 9-PCSK9, lipoprotein(a)-Lp(a) and high‐sensitivity C‐reactive protein-hsCRP] and the cardiovascular events; to evaluate the relationship between the 3 biomarkers mentioned above and the renal outcome...
Article
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PurposeThe aim of this retrospective study was: to analyze the epidemiological patterns of the kidney disease based on clinical and histological features in a single-center in the N-E region of Romania, between 2011 and 2019 and to compare the biopsy results with the others periods, as well as the results from other countries.Methods We studied 442...
Article
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Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent hereditary kidney disease. Recent evidence suggests that the pathogenesis of ADPKD is a complex web of abnormal cellular processes including altered cell signaling, disordered cell metabolism, impaired autophagy, increased apoptosis, mitochondrial dysfunction, and chronic in...
Article
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Purpose of Review Chronic kidney disease (CKD) is epidemic throughout the word. Despite various novel therapeutic opportunities, CKD is still associated with high morbidity and mortality. In CKD, patient’s chronic inflammation is frequent and related with adverse outcomes. Both innate and adaptive immunity are dysfunctional in CKD. Therefore, it is...
Article
Background: Metabolic syndrome is a growing twenty first century pandemic associated with multiple clinical comorbidities ranging from cardiovascular diseases, non-alcoholic fatty liver disease, and polycystic ovary syndrome to kidney dysfunction. A novel area of research investigates the concept of fatty kidney in the pathogenesis of chronic kidn...
Article
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Background COVID-19-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients three months after their COVID-19 diagnosis. Methods We analyzed data on dialysis patients diagnosed with COVID-19 from February 1st, 2020-March 3...
Preprint
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Background The coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) produced a pandemic since March 2020 by affecting more than 243 million people with more than 5 million deaths globally. SARS-CoV-2 infection is produced by binding to angiotensin-converting enzyme, which among other sites is hig...
Article
Full-text available
Background Despite the severity of ethylene glycol intoxication, there is a paucity of studies that analyze prognostic factors. This study aims to determine prognostic factors with impact on core outcomes like death and prolonged kidney injury (KI) in ethylene glycol poisoned patients. Methods We retrospectively assessed prevalence, clinical and b...
Chapter
Magnesium (Mg) is one of the most important cations in the human organism playing an important role in many vital processes, including neuromuscular, enzymatic reactions, neurotransmitter release, or chronic kidney disease (CKD) mineral and bone disease metabolism. Moreover, higher levels of magnesium in the body are positively correlated with impr...
Chapter
Diabetic osteopathy, one of the most recently recognized complications of diabetes mellitus, is characterized by low bone turnover, microarchitectural changes, and low vitamin D levels accompanied by a negative calcium balance – all leading to an increased fracture risk, independent of bone density which varies considerably. Although generally youn...
Article
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Kidney transplant recipients and dialysis patients constitute a risk group for severe COVID-19. They are highly advised to get vaccinated according to the current guidelines. However, data on antibody response, cell responses and protection from events, and factors that might alter this response after a routine full series of vaccination remain inc...
Article
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Purpose of Review With the prolongation of life expectancy, the gap between lifespan and “health span,” the disease-free lifespan, has been widening due to the massive burden of age-related chronic diseases and research on healthy aging has been gaining momentum. A growing body of evidence suggests that diet is a strong determinant of healthy aging...
Article
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Psychological stress is a well-established risk factor for cardiovascular disease (CVD). Heart rate variability (HRV)-biofeedback could significantly reduce stress levels and improve autonomic nervous system function and cardiovascular endpoints. We aimed to systematically review the literature to investigate the impact of HRV modulation through HR...
Article
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The increasing production of modern medication emerges as a new source of environmental pollution. The scientific community is interested in developing alternative, ecological therapies in asthma. Halotherapy proved its benefits in asthma diagnosis, treatment, and prevention and may represent a reliable therapeutic addition to the allopathic treatm...
Article
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RESULTS: 115 patients died, of which 47 due to cardiovascular reasons during a mean follow-up of 37.6 (17.5 SD) months. In the whole cohort, systolic BP (SBP) and pulse pressure (PP) showed a nonlinear U-shaped association with all-cause and cardiovas-cular mortality (see Figure exemplarily for cardiovascular mortality). In linear subgroup analysis...
Article
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Ischemic heart disease represents the leading cause of death, emphasizing risk stratification and early therapeutic intervention. Heart rate variability (HRV), an indirect marker of autonomic nervous system activity, was investigated extensively as a risk factor for adverse cardiovascular events following acute myocardial infarction. Thus, we syste...
Article
Sleepiness, fatigue, and stress in drivers are the leading causes of car crashes. In the late two decades, there is an endeavor to monitor vital signs, stress levels, and fatigue using adapted sensors supported by technological advances. To the best of our knowledge, this systematic review is the first to investigate the role of HRV measurement...
Article
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Clostridioides difficile infection (CDI) is a health issue of utmost significance in Europe and North America, due to its high prevalence, morbidity, and mortality rate. The clinical spectrum of CDI is broad, ranging from asymptomatic to deadly fulminant colitis. When associated with chronic kidney disease (CKD), CDI is more prevalent and more seve...
Article
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Diuretic volume reduction continues to be the mainstay of congestive heart failure (CHF) management globally. However, diuretic resistance is a critical topic that lacks standardized evidence-based management guidelines accounting for mechanisms of diuretic resistance, renal function, and co-morbidities. Major healthcare utilization consequences re...
Article
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The value of lung ultrasound (LU) in assessing extravascular lung water (EVLW) was demonstrated by comparing LU with gold-standard methods for EVLW assessment. However, few studies have analysed the value of B-Line score (BLS) in guiding fluid management during critical illness. The purpose of this trial was to evaluate if a BLS-guided fluid manage...
Article
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PurposeAlmost all CKD patients have a poor nutritional status, while elderly CKD patients are specifically frail and malnourished. Our aim is to conduct a systematic review of the up to date primary studies that look at methods of improving nutritional status in CKD patients in the elderly demographic. MethodsA focussed and sensitive search strateg...
Article
Lung congestion, estimated by lung ultrasound is a risk factor for all-cause and cardiovascular mortality in patients on chronic hemodialysis and may be useful to guide ultrafiltration and drug therapy in this population. In an international, multi-center randomized controlled trial (NCT02310061) we investigated whether a lung ultrasound-guided tre...
Article
Despite increasing awareness and therapeutic options chronic kidney disease (CKD) is still and important health problem and glomerular diseases constitute and important percentage of CKD. Proteinuria/albuminuria is not just a marker; but it also plays a direct pathogenic role in renal disease progression of CKD. Glomerular filtration barrier (GFB)...
Article
Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) are promising drugs to treat chronic kidney disease (CKD) patients with or without diabetes mellitus (DM). Besides improving glycemic control, SGLT2i are cardioprotective and kidney protective and decrease body weight, serum uric acid, blood pressure, albuminuria and glomerular hyperfiltration...
Article
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Background and Objectives: Two-dimensional speckle tracking echocardiography (2D-STE) is viewed as an outstanding technique, competent of uncovering earlier subclinical myocardial anomalies compared to conventional echocardiography. A few endeavors adopted 2D-STE as a tool to estimate right ventricular (RV) function in subjects with end-stage kidne...
Article
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Background Older adults at a higher risk of adverse outcomes and mortality if they get infected with Severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2). These undesired outcomes are because ageing is associated with other conditions like multimorbidity, frailty and disability. This paper describes the impact of frailty on coronavirus dis...
Article
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Background COVID-19 has exposed hemodialysis patients and kidney transplant recipients to an unprecedented life-threatening infectious disease raising concerns about kidney replacement therapy (KRT) strategy during the pandemic. The present study investigated the association of type of KRT with COVID-19 severity adjusting for differences in individ...
Article
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Background: There is concern about potential deleterious effects of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) in patients with COVID-19. Patients with kidney failure, who often use ACEi/ARB, are at higher risk of more severe COVID-19. However, there are no data available on the association of ACEi/AR...
Article
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Background: The consumption of sweetened beverages is associated with increased risk of metabolic syndrome, cardiovascular disease, and type 2 diabetes mellitus. Objective: We hypothesized that the metabolic effects of fructose in sugary beverages might be modulated by the speed of ingestion in addition to the overall amount. Design: Thirty he...
Article
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The aim of this study was to identify by classification and regression tree (CART) analysis groups of patients with different survival patterns in a population of patients with heart failure and reduced left ventricular ejection fraction (HFrEF) by using standard methods of heart function assessment, as well as well as utilizing non-traditional app...
Article
The most significant complication of end‐stage kidney disease (ESKD) is cardiovascular disease, mainly coronary artery disease (CAD). Although the effective treatment of CAD is an important prognostic factor, whether percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is better for treating CAD in this group of patien...
Article
Sodium and ultrafiltration profiling are method of dialysis in which dialysate sodium concentration and ultrafiltration rate are altered during the course of the dialysis session. Sodium and ultrafiltration profiling have been used, commonly simultaneously, to improve hemodynamic stability during hemodialysis. Sodium profiling is particularly effec...
Article
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Background and Aims Studies examining kidney failure patients with COVID-19 reported higher mortality in hemodialysis patients than in kidney transplant recipients. However, hemodialysis patients are often older and have more comorbidities. This study investigated the association of type of kidney replacement therapy with COVID-19 severity adjustin...
Article
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Background and objectives: cardiovascular complications (CVC) are the leading cause of death in patients with chronic kidney disease (CKD). Standard cardiovascular disease risk prediction models used in the general population are not validated in patients with CKD. We aim to systematically review the up-to-date literature on reported outcomes of co...
Article
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Whether one wants to or not, interactions between the heart and the kidneys will exist and manifest nevertheless. Both from theoretical and clinical perspectives, it seems pretty justified the need for a subspecialty of cardio-nephrology. Our editorial is a cardiologist perspective on the paper of Diez and Ortiz published in the CKJ, related to the...
Article
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Conventional percutaneous coronary interventions (PCIs) frequently cause severe complications in chronic kidney disease (CKD) patients. Low-to-zero contrast intravascular ultrasound (IVUS) guided PCIs are promising alternatives in the CKD setting. We aim to systematically review up-to-date literature that have reported data and outcomes of low-to-z...
Article
Increased serum uric acid (SUA) levels have been associated with various pathologic processes such as increased oxidative stress, inflammation, and endothelial dysfunction. Thus, it is not surprising that increased SUA is associated with various adverse outcomes including cardiovascular (CV) diseases. Recent epidemiological evidence suggests that i...