CORONA MEETS KIDNEY

Why corona is not just a lung disease

Covid-19 disease has become known in the population as a lung disease due to flu-like symptoms such as dry cough, shortness of breath, muscle pain and fever. Interestingly, however, 20% of those affected initially only experience gastroenterological symptoms such as nausea, abdominal pain and diarrhea and the SARS-CoV-2 infection only becomes apparent on chest CT.

SARS-CoV-2 infection is triggered by the binding of the spike protein of the virus to ACE2. ACE2 is an enzyme that is expressed in many cells. This enzyme plays an important role in the renin-angiotensin-aldestorone system (RAAS), a regulatory circuit that controls the volume balance (distribution of body water) of the organism and regulates blood pressure.

Research has now shown us that the SARS-Cov coronavirus enters the infected cell by binding to ACE2 and initiates the disease process there. This process can therefore be observed not only in the lungs, but also in cells of other organs that produce this ACE2 enzyme, for example in heart muscle cells, vascular cells of the heart, in the kidneys, in the intestine and, as is currently known, in the lungs.

Abnormalities in the heart, intestines and kidneys must therefore also be taken into account in corona diagnostics.

Back in May 2020, the working group led by Prof. Tobias Huber, nephrologist at the UKE in Hamburg, discovered SARS-CoV-2 in the kidneys of deceased COVID-19 patients and proved that these organs are also targets of SARS-CoV-2.

The same working group has now shown that virus replication also takes place there, which may have clinical consequences: The detection of viral RNA in the kidneys correlated with a higher rate of acute kidney failure and higher mortality. As the German Society of Nephrology (DGfN) concludes from these data, patients with severe cases of COVID-19 require nephrological care and follow-up.

More on the matter here