COVID-19 in patients with chronic kidney disease |
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COVID-19 in patients with chronic kidney disease
eMediNexus,  21 April 2020
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Novel coronavirus disease is a condition newly discovered in the end of 2019 and started in the Wuhan city of China. It is caused by SARS-CoV-2 virus and its main clinical manifestations include acute respiratory illness with pneumonia.

Symptoms in COVID 19

Some important facts about COVID-19

  • COVID-19 is more contagious than previous coronavirus infections, SARS and MERs.
  • It spread by human-to-human transmission through droplets from coughing or sneezing, faecal or direct contact, and has an incubation period estimated at 1 to 14 days.
  • Pregnant women, the newborn and the elderly, and patients with comorbidities (such as diabetes mellitus, hypertension, cardiovascular, chronic lung and chronic kidney disease) are especially susceptible to COVID 19 infection and have increased likelihood of severe illness.
  • Infection has been reported in all age groups including in children.

The impact of COVID -19 on kidneys

Currently, there is no evidence to suggest that coronavirus affects the kidneys adversely in those patients who have mild to moderate infection. However, almost 25% to 50% of patients who develop severe infection and need hospitalization have been reported to have kidney abnormalities. These may be manifested as increased excretion of protein and red blood cells in urine. A small percentage of people (less than 15%) may develop a decline in filtration function of kidneys (acute kidney injury).

COVID-19 in patients with chronic kidney diseases

CKD patients are at an increased risk for COVID -19 infection, especially those on dialysis and kidney transplant recipients. Haemodialysis patients may have milder clinical disease than other patients with COVID-19 infection. All patients are recommended to continue their medicines in prescribed doses including ACE inhibitors unless advised so by their doctor.

COVID-19 and dialysis patients

COVID-19 is a major threat to patients on dialysis, particularly, in-centre haemodialysis. Uremic patients are highly vulnerable to infection and may show larger changes in clinical symptoms and infectivity. In addition, patients with COVID-19 infection need to come to the dialysis centre for regular dialysis. This places the dialysis patients at a heightened risk of transmission of infection, including transmission to health care teams, other patients and all others in contact.

  • COVID-19 primarily manifests as an acute respiratory illness with pneumonia, but can affect multiple organs
  • Novel coronavirus is more contagious than previous coronavirus infections (SARS and MERS)
  • There is no evidence that COVID-19 infection affects the kidneys adversely in those with mild to moderate infection
  • The long-term health effect of kidney injury on survivors of COVID-19 infection is not known
  • COVID-19 infection presents a special threat to patients with CKD, especially patients on dialysis and kidney transplant recipients

Resource: Recommendations for the Novel Coronavirus 2019 Epidemic. International Society of Nephrology. Accessed from: https://www.theisn.org/covid19/recommendations Accessed on: April 15 2020.

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