One of the most serious problems being investigated associated with COVID-19 is acute respiratory syndrome (ARDS), which begins when a person does not get enough oxygen. ARDS can be life threatening.
According to a recent study that was done, nearly 30-40% of people in COVID-19 hospitals develop ARDS, and approximately 70% of fatal cases involve this problem.
However, as the epidemic continues, researchers are finding evidence that COVID-19 can cause many symptoms and lead to many different problems, not just ARDS. One of them is AKI, also known as severe kidney failure.
In this Special Feature, Medical News Today examines what experts know so far about COVID-19 and AKI – including the effect on people with both conditions – and what they still need to learn.
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COVID-19 and kidney damage
When SARS-CoV-2 enters cells, the first step is that the virus attaches itself to angiotensin converting enzyme 2 (ACE-2) receptors.
These receptors reside in the cells that line the kidneys, lungs, intestinal tract, heart, and blood vessels. They help regulate blood pressure by regulating angiotensin levels, a protein that raises blood pressure by blocking blood vessels.
Some studies suggest that SARS-CoV-2 may be more susceptible to kidney disease than other organs because ACE-2 expression is much higher in proximal tubule cells. The adjoining lump is a large part of the kidneys that controls the amount of water and nutrients in the blood.
As soon as SARS-CoV-2 enters the kidney cells, it begins to replicate using cell machinery. Cells tend to store damage during this process.
The immune system also triggers an inflammatory response as soon as it detects an invading virus. This response can lead to further damage to healthy muscles.
AKI occurs when the kidney damage is large enough that the organ can no longer properly filter blood. This disruption causes the waste to build up in the bloodstream, making it harder for the kidneys to function and maintain fluid balance.
After concerns about remdesivir, a drug used by doctors to treat COVID-19, could cause AKI, the European Medicines Agency (EMA) recently to find no evidence of a link.
Some people with AKI may have no symptoms at all. However, some people may experience symptoms such as decreased urination, unexplained fatigue, and swelling around the eyes and ankles and legs.
In severe or untreated cases, AKI can lead to organ failure, which can lead to coma, coma, and death.
COVID-19 and AKI
The researchers also need to gather more patient data to build their understanding of the relationship between the kidney injury and the COVID-19. However, many studies show that the AKI occurs more frequently during the current epidemic than that during the 2003 SARS epidemic.
Studies published in February 2021 reported various values. According to one study, 4-37% of COVID-19 cases involved kidney disease, while AKI had 50% of cases in COVID-19 patients in hospitals.
A recent review paper contradicts these findings, noting that an estimated 10% of people who sleep in COVID-19 hospitals develop AKI. Several other studies report very high rates, however. In a study conducted in September 2020, 81% of patients were admitted to the intensive care unit (ICU) of COVID-19 which established AKI.
By comparison, during the 2003 SARS epidemic, studies showed that an estimated 6.7% of people with SARS contracted AKI. Also, doctors found that AKI was a problem in 91.7% of fatal cases.
For example, age seems to play a role. In a recent small group analysis that was done which had an involving of people with COVID-19, the AKI affected approximately 12% of people who were under-60 age group. While on the other hand, it affects only near to about 6% of people in the under-60 age group.
People with pre-existing kidney disease or other chronic diseases, such as high blood pressure, diabetes, heart disease, and obesity, are also more likely to develop COVID-19 and experience more severe symptoms.
Treatment of kidney conditions, such as dialysis or immunosuppressants after receiving a kidney transplant, also lowers the immune system.
Dialysis is a procedure in which a machine filters a person’s blood because his kidneys can no longer perform this function. Doctors prescribe anti-retroviral drugs to people who have received transplants.
Both of these factors could pose a high risk of potent COVID-19. As a result, researchers and kidney organizations are urging countries to begin prioritizing people with existing COVID-19 kidney disease.