COVID-۱۹ and nephrology; a letter to the editor on current concepts

Coronavirus disease (COVID-۱۹) is a recent disease that originated in China in late ۲۰۱۹ (۱). Previous coronavirus infections, such as SARS-CoV and MERS-Co-V, have infected more than ۱۰,۰۰۰ people in the past two decades, with mortality rates of ۱۰% and ۳۷%, respectively (۲). COVID-۱۹ is more contagious and has a lower mortality rate than MERS-Co-V and SARS-CoV. COVID-۱۹ likely to cause more severe disease, in patients with chronic kidney disease (CKD), in patients on chronic dialysis (HD), and those living with a kidney transplant (KT) (۳). Renal abnormalities associated with the COVID-۱۹ include proteinuria, hematuria, elevated serum creatinine, elevated blood urea nitrogen, and reduced glomerular filtration rate (GFR <۶۰ mL/min/۱.۷۳ m۲) (۴). Another major problem in COVID-۱۹ patients is impaired renal function. Hence, about two-thirds of expired patients have renal dysfunction, and about one-fourth of patients discharged after recovery from COVID-۱۹ had impaired renal function. It is also documented that only ۱۵% of the kidney function remained in COVID-۱۹ patients (۵). COVID- ۱۹ involves the kidneys and causes acute renal failure, but the effect of the virus in patients with CKD, is not yet fully known (۶). However, CKD appears to be associated with severe COVID-۱۹ (۷). In a cohort study of ۱۵۹۱ patients admitted to intensive care units in Lombardy, Italy, with laboratory-confirmed COVID-۱۹, CKD was observed in ۳% of patients (۸). In addition, CKD was reported in ۲۶۸ (۵%) study participants and end-stage renal disease (ESRD) was reported in ۱۸۶ (۳.۵%) study participants, out of a total of ۵۷۰۰ admissions with confirmed COVID-۱۹ infection who were admitted to ۱۲ New York City hospitals, at baseline (۹).