Long Haul Covid-19 and Chronic Kidney Disease (CKD)
In the US, the end of the Covid-19 pandemic is drawing near, but the medical community is preparing for a global health event of a different sort. Most patients infected with COVID-19 get better within a few weeks, but certain individuals continue to experience symptoms related to the lungs, heart, or kidneys. What are these effects, and how do they impact the body’s key systems? There is still much to learn about COVID-19 Long Haul Syndrome.
In a recent interview with nephrologist Joseph Lee, M.D., based in southern California, he spoke about the challenges of understanding the impact of Covid-19 on the kidneys.
COVID-19 Long-haul Syndrome and Clinics
One of the main challenges in facing a global pandemic is understanding the complex impacts of the virus on the body. While this involves treating the worst immediate symptoms in a hospital setting, patients can experience long-term symptoms as well.
Though the global medical community has been treating the Covid-19 virus for well over a year, much is still unknown about its long-term effects on people’s health, especially with regards to the kidneys.2 “It’s a very prominent and unfortunate issue,” says Dr. Lee. “When you get discharged from the hospital most of the time people are fine, but problems can start after that.”
To better understand the influence of Covid on the kidneys, many institutions such as NYU, UCSF, Johns Hopkins, UCLA and others have set up long-term clinics so that people who have been treated for symptoms related to Covid-19 can return for ongoing care.
Dr. Lee explains that this “passive” approach, however, has its challenges. “When a patient gets really sick, they are supposed to call these clinics. The problem is that when people get really ill, they are usually unable to go to these clinics and will wind up in local facilities.”
Furthermore, the patients that do contact the clinics must experience a certain level of discomfort before they feel compelled to reach out for medical advice. What about patients with more subtle effects? What about side-effects that have been misdiagnosed?
The medical community is still largely left in the dark with regards to the long-term impact of Covid-19. “The passive approach is not going to be enough,” says Dr. Lee. “We need to actively track these people down before they get really sick.”
How can Long Haul Syndrome affect the kidneys?
COVID 19 has clearly become a potential new risk factor for kidney disease. Of those who got COVID, approximately 20% were hospitalized. Of those hospitalized, 35-40% suffered from this new kidney disease, and they were slower to recover than other patients. Of these patients suffering from kidney disease due to Covid-19, 20% are on dialysis, with a tragically high mortality rate of 50%.
Based on these statistics on patients hospitalized from Covid-19, almost 1% have died of kidney disease while many more may suffer from its symptoms long-term. This is a vast issue when considering the infection and hospitalization rates global population. Where Dr. Lee works in Riverside County, CA alone, over 300,000 positive Covid cases have been confirmed.
“We need to trace and track down COVID patients, figure out complications, treat, educate, and figure out the long-term effects,” insists Dr. Lee. When it comes to preparing for the long-term impact of Covid-19, this active approach is critical, but the work is still in its early stages.
A complex issue for minorities and at-risk demographics
Unfortunately, the relationship between Covid-19 and CKD is further compounded by social determinants of health.
We already know that kidney disease disproportionately affects minority groups, which make up 70% of those with CKD. The past year has also shown that minorities have a higher risk of contracting Covid-19. Today, many minority groups remain under-vaccinated, and estimates suggest that minorities make up 70% of unvaccinated Americans.
“These demographics are already at risk of kidney disease, and Covid-19 is making the situation worse,” says Dr. Lee. “This is truly a public health issue.”
What can I be doing?
Though it is tempting to assume that the pandemic is behind us, Dr. Lee warns us that it will continue to be “very serious public health issue in the future” and that we “have to look at Covid-19 with a different perspective.”
If you have yet to do so: get vaccinated. Covid-19 is not only a risk to your health, but it affects family and everyone around you, especially those that are more at risk to health complications. Encourage them to get vaccinated as well. Offer to drive them to their appointment or help them research the best way to do so.
Research out your nearest long-term Covid clinic. If you later experience symptoms that might be related to a past infection of COVID-19, look for a long-term clinic near you. Even if you never tested positive for Covid-19, you can help others be aware of potential long-term risks as well.
Follow up with your doctor. Communicate with your family doctor about your ongoing health status, especially if you have previously tested positive for Covid-19. The more data that your doctor has to work with, the better they can understand the ongoing impact of the virus. Pay special attention to your standard physical and urinalysis tests, and discuss the results with your doctor.
A season for hope, caring, and collaboration
First and foremost, the past 18 months have shown the true value of communication and collaboration within the international medical community. This spirit helped develop multiple vaccines in record time, and has changed the way we think about transmission and treatment of infectious diseases.
Today, we have the perfect opportunity to maintain this momentum and foster continued collaboration. Only by sharing knowledge, data, and insights will we be able to fully understand the impact and long-term effects of COVID-19 and Long Haul Syndrome.
As always, please send us your thoughts on the issue, and let us know how we can continue to empower YOU in your healthcare journey.
- Kępińska, A. P., Iyegbe, C. O., Vernon, A. C., Yolken, R., Murray, R. M., & Pollak, T. A. (2020). Schizophrenia and Influenza at the Centenary of the 1918-1919 Spanish Influenza Pandemic: Mechanisms of Psychosis Risk. Frontiers in psychiatry, 11, 72.
- “COVID-19 and the kidney” Mohamed Hassanein et al; Cleveland Clinic Journal of Medicine October2020, 87 (10) 619-631