Renal Patients And Covid 19

The SARS-CoV-2 (novel coronavirus) virus was first detected in Wuhan, China in December 2019. With this disease affecting the whole world over time, it was declared by the World Health Organization (WHO) on March 11, 2020 that Covid-19 has now become a pandemic.

The novel coronavirus is defined as zoonotic. The word zoonotic means that an animal contracted the disease and then passed it to humans. After transmission from animals to humans, the person infected with the virus can now infect other people. The most common way of transmission of Covid-19 disease is through particles called “droplets”. Although they do not show any symptoms, the viruses in the droplets scattered in the air during sneezing, coughing or talking can be taken into the body during breathing by people in the environment. The fact that droplets are currently considered to be the main mode of transmission of the novel coronavirus explains why masks, social distancing and frequent hand washing are so widely emphasized to protect against the disease.

In addition to droplet transmission, the novel coronavirus, which can persist on moist surfaces for some time, can also infect people who touch their nose, mouth or eyes after contact with these surfaces. Therefore, avoiding contact with risky surfaces or washing hands with disinfectant products or soap and water after contact are necessary measures to prevent the spread of the disease.

• • Table of Contents
  • What is the disease-causing mechanism of the SARS-CoV-2 virus?
  • What are the symptoms of COVID-19?
  • How is Covid-19 disease diagnosed?
  • What is the effect of Covid-19 on the kidneys?
  • What is the impact of the pandemic on people with kidney disease?

What is the disease-causing mechanism of the SARS-CoV-2 virus?

The novel coronavirus disease 2019 (Covid-19) is a major threat to the world. The age group most affected by this disease is individuals between the ages of 30 and 79.

As a result of the researches, the place where the nose and mouth open into the nasal passages is determined as the area where the virus is found most in people who are symptomatic or who harbor the virus in their body, even if they do not show symptoms. Over time, the virus can break away from the area and spread to the lungs in the form of small particles or by gradually descending down the airway.

The SARS-CoV-2 virus tends to adhere to cells with a finger-like protrusion at the back of the nose and mouth and interacts with these cells through an enzyme called ACE2. The ACE2 enzyme, which the virus uses to interact with cells, is mainly found in the bronchi, lung tissue, heart, kidney and along the digestive tract.

What are the symptoms of COVID-19?

One of the important features of Covid-19 disease is the possibility of continued carriage for periods ranging from 2 days to 2 weeks without causing any symptoms in people.

It has been determined that the symptoms of Covid-19 disease, which is the 3rd outbreak of the coronavirus family in the last 20 years, appear within 2-14 days after exposure to the virus. Several signs and symptoms are currently considered to be associated with Covid-19 disease:

• • Shortness of breath
  • Cough that gets worse and worse
  • Body temperature that starts with a mild fever and then gradually increases
  • Fatigue, weakness
  • Sore throat

Apart from these symptoms, there are other symptoms that may occur during the course of Covid-19 disease, although they are rare:

• • Chills, chills
  • Headache
  • Muscle pain
  • Loss of the senses of smell and taste

How is Covid-19 disease diagnosed?

As in the diagnosis of other virus-induced diseases, the presence of the disease can be revealed by examining blood, saliva or tissue samples of people in the laboratory in the disease caused by the new type of coronavirus. One of the most commonly used tests for the diagnosis of Covid-19 is to investigate the presence of virus materials in samples taken from the nose and the back of the mouth with a cotton swab. The test used for this purpose is called the polymerase chain reaction (pcr) test.

The polymerase chain reaction test is used to check for the presence of inheritance materials of the new type of coronavirus in the samples taken. If both of the 2 genes involved in the inheritance of the novel coronavirus are detected in the test result, the result of this test is expressed as positive. Tests in which only one of the 2 genes is detected are considered inadequate, while the result of the test is interpreted as negative if the inheritance materials of the virus cannot be detected.

In addition to the PCR test, physicians can also use computed tomography imaging to diagnose Covid-19. This radiological method helps to determine whether the person’s respiratory system is affected by the disease.

In the vast majority of cases, no problems are encountered in PCR test results. However, it should be kept in mind that in very early stages of the disease, the test results may be different from normal due to the low viral load (the amount of virus in the body).

What is the effect of Covid-19 on the kidneys?

Some people infected with Covid-19, especially those who have severe disease and continue their treatment in intensive care units, may develop kidney damage.

Urine and blood analyzes are important for monitoring this situation.

There are a number of conditions that are considered risky for the development of kidney damage after Covid-19.

Hypertension (high blood pressure) and diabetes are examples of conditions that predispose to pandemic-related kidney damage.

Since the enzyme that the novel coronavirus uses to interact with cells in the human body is also found in the kidneys, it can be said that the kidneys are one of the organs targeted by the disease.

In addition to the direct damage caused by the virus to the kidneys, pneumonia that develops during the course of Covid-19 may lead to a decrease in the amount of oxygen reaching the kidneys and as a result of this development, some kidney-related problems may occur in the person.

Damage to the kidneys can also occur during the disease due to the fact that Covid-19 disease creates an excessive inflammatory response in the body and increases the susceptibility to clotting.

What is the impact of the pandemic on people with kidney disease?

Epidemiologic studies of the current coronavirus pandemic show that one in 4 people who are ill have a more severe illness. If Covid-19 is severe, there may be a risk of damage to the kidneys in addition to the lungs, which are known to be mainly affected. Chinese studies have shown that people infected with Covid-19 can develop sudden kidney damage at rates ranging from 3% to 15%.

People with chronic diseases related to kidney or other organs known before the pandemic constitute the risk group where Covid-19 disease may be more severe.

The immune system of kidney patients undergoing dialysis treatment may be negatively affected depending on the treatment. Therefore, these people may have a predisposition to infectious diseases due to weakened body defenses. Despite this situation, it is important to continue dialysis treatment without interruption.

Dialysis patients should continue their planned dialysis treatment by taking the necessary precautions required by healthcare professionals and authorities.

Similarly, kidney transplant recipients may be somewhat vulnerable to infectious diseases due to the immunosuppressive drugs they are taking to prevent organ rejection, but it is vital that they continue to take their medication.

Both chronic kidney disease patients and people with other serious and chronic illnesses are known to be at risk for the course of Covid-19.

These people are advised to be more vigilant during the pandemic, to take stricter precautions, to keep up with their treatment and to stay at home as much as possible, except when treatment is needed.