Another consequence of kidney damage “long COVID”

Thursday, September 2, 2021 (HealthDay News)-People hospitalized with COVID-19, and even mild cases, can cause permanent damage to them. kidney, A new study was found.

A study of more than 1.7 million patients in the US veterans system adds concerns about the protracted effects of COVID, especially among people who are ill enough to require hospitalization.

Researchers found that COVID survivors were at increased risk of various types of kidney damage, from impaired renal function to advanced renal failure, months after the initial infection.

The most severely ill (in need of ICU care) were at greatest risk of long-term kidney damage.

Similarly, patients who developed acute kidney injury during COVID hospitalization were at higher risk than COVID patients who had no obvious renal problems during hospitalization.

But what is surprising, however, was that the latter patient was not outside the forest, said Dr. F. Perry Wilson, a kidney expert who was not involved in the study.

They were still about 2-5 times more likely to develop some degree of renal dysfunction or disease than VA patients who were not diagnosed with COVID.

“What stands out is that even patients who did not have acute kidney injury at the time of admission have a full range of these risks,” said Wilson, an associate professor at Yale School of Medicine in New Haven, Connecticut. I am.

According to Wilson, there are some questions about how kidney problems are particularly related to COVID, or to getting sick in the hospital. For example, it is unclear how their kidney function is compared to that of patients hospitalized for influenza.

However, the study found that even Veterans Affairs patients infected with COVID at home were at increased risk of kidney problems.

Is it because of inflammation?

Dr. Ziyad Al-Aly, an assistant professor at Washington University in St. Louis School of Medicine, said:

Why did Wilson say the “big problem”?

“Does this reflect some in progress? Immune system With stimulation inflammation“We need more research to understand that,” he said.

Investigation result -Released on September 1st Journal of the American Society of Nephrology –Based on medical records of over 1.7 million VA patients. Of these, 89,216 were diagnosed with COVID between March 2020 and March 2021 and were still alive 30 days later.

This study examined the risk of patients developing different types of kidney problems in the months following 30 days.

Overall, COVID patients were more likely to exhibit a significant reduction in renal glomerular filtration rate (GFR). This is a measure of how well an organ filters waste products from the blood.

The study found that over 5% of COVID patients showed a GFR reduction of more than 30%. And their risk was 25% higher than in the general VA patient population.

According to Wilson, an adult naturally loses about 1% of kidney function, so a 30% reduction in GFR is similar to a 30-year loss of kidney function.

The study also looked at the risk of acute kidney injury, in which organs suddenly lose function. May cause symptoms such as swelling of the legs, Malaise Dyspnea, but may not cause obvious problems.

Patients with COVID were almost twice as likely to develop acute kidney injury, depending on the severity of their initial COVID.

Will the damage continue?

Hospitalized patients were 5-8 times more likely to develop acute kidney injury than non-COVID patients. People who were ill at home with COVID were at a 30% higher risk than those in the non-COVID group.

According to Al-Aly, it is not yet known what that means for the long-term kidney health of COVID patients.

One current question, he said, is whether the decline in GFR will level off in some patients.

With regard to acute kidney injury, Wilson said people can then recover from it without permanent harm. He also said that if a decrease in GFR is associated with acute kidney injury, it could rebound.

Some patients in this study developed end-stage renal disease. These odds were highest among COVID patients in the ICU. They develop the disease at a rate of about 21 cases per 1,000 patients annually, 13 times more risk than other VA patients. There was also a smaller risk among other COVID patients, whether hospitalized or not.

The limitation of the study is that most of the Veterans Affairs patients were older men. According to Al-Aly, it is unclear how widely the results will be applied.

The risks presented to non-hospitalized patients are also somewhat vague. They are far from a unified group, both doctors said.

Wilson believes that those who are slightly affected by COVID are less likely to develop kidney problems, but those who are “really knocked out for a few weeks” may be at relatively high risk.

According to Al-Aly, the good news is that renal dysfunction can be easily detected through basic blood tests performed during primary care visits.

Wilson said this type of test may be worthwhile for people with more severe COVID.

For more information

The National Kidney Foundation COVID-19 and kidney disease..

Source: Assistant Professor, University of Washington School of Medicine, St. Louis, Ziyad Al-Aly, MD; F. Perry Wilson, MD, Associate Professor, Medicine, Yale Medical School, New Haven, Connecticut; Journal of the American Society of Nephrology, Online, September 2021