Coronavirus | ‘Renal patients at high risk from COVID-19’

March 11 is observed as World Kidney Day

When a family of three from Bengaluru, including a 53-year-old renal transplant individual, contracted COVID-19 in August, the family only prayed that the disease should not create more complications in the kidney recipient.

While two members from the family developed classical COVID-19 symptoms, including high fever, cough, and loss of taste/smell, the person who had undergone the transplant had very mild symptoms. Doctors said this was because of his poor immune response due to immunosuppressants.

No classical symptoms

City-based nephrologists, who have noticed a high incidence of COVID-19 among people with kidney disease and other severe chronic medical conditions, said although persons with renal issues and those who have undergone transplant did not exhibit classical symptoms, they were at a higher risk of more severe illness.

To study this aspect, a group of doctors from Manipal Hospitals documented the impact of COVID-19 on patients with kidney disease, kidney recipients, and those on dialysis in a review article titled ‘Coronavirus Disease 2019 and the Kidney’. The article, published in the Journal of Internal Medicine , an official publication of the Association of Physicians of India, Karnataka chapter, was compiled by Ravi Jangamani, Chakravarthy Thirumal, and Sankaran Sundar from the Department of Nephrology at Manipal Hospitals in Bengaluru.

“Besides our own findings, we have also put together global observations regarding the impact of the virus on the kidneys of patients,” Dr. Jangamani told The Hindu on Thursday. “Patients with chronic kidney diseases (CKD) and immune- mediated kidney diseases should be regarded as at risk to experience a more severe disease mediated kidney diseases should be regarded as at risk to experience a more severe disease of immunosu- ppression drugs,” he said.

Dr. Sundar, head of international transplant services at the hospital, said that 20% to 40% of critically ill COVID-19 patients who did not have any renal issues prior to the infection had developed acute kidney injury.

“Those predisposed with renal issues were the worst hit. As most did not exhibit fever or other classical symptoms, they did not seek timely medical advice and went for self-medication. This led to complications at a later stage and we have noticed high mortality in such patients,” he said.

Pointing out that the pandemic had hit those on dialysis the most, Dr. Sundar said, “Dialysis patients had a high exposure to the virus as they had no other go but to visit hospitals for the procedure.”

Dr. Jangamani said that over 20% of patients who sought dialysis at Manipal Hospitals were infected.

Dialysis patients who were infected by the virus in the city had a tough time in the initial months of the pandemic as COVID-dedicated hospitals did not have dialysis facilities. However, things changed for the better after August when private hospitals set up dedicated COVID-19 wards.

To mark World Kidney Day, Manipal Hospitals provided free vaccination to everyone undergoing dialysis at all its centres.

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