Urology scientists from Sechenov University made an encouraging discovery
Until now, it was believed that one of the target organs that the coronavirus hits are the kidneys . Some doctors attribute the increase in the number of inflammatory kidney diseases to the causative agent of covid. However, by all accounts, this is most often unjustified. SARS-CoV-2 in this case was not as terrible as it is painted. An encouraging discovery was made by researchers at the Institute of Urology and Human Reproductive Health, Sechenov University .
Within six months, scientists and urologists examined 330 volunteers. Their condition was monitored, blood and urine tests were taken to determine markers of inflammation and kidney damage. Changes in tissues in the organ were assessed using computed tomography. All patients had a confirmed diagnosis of COVID-19 based on PCR tests.
WHAT WE CAN FIND OUT
The researchers set themselves the task of finding out whether the main function of the kidneys – their ability to purify the blood – is impaired in covid. The first signal of a dangerous violation is the detection of protein in the urine. CT also monitors the damage to the kidney weavers.
Based on the results of surveys and observations, scientists came to unexpected conclusions:
- the cleansing ability of the kidneys decreased in less than 10% of those infected with coronavirus (9.6%). In this case, the violation was noted only in seriously ill patients;
- no one had any visible kidney dysfunction (on CT);
None of the patients had a coronavirus in their urine.
Based on the results obtained, scientists suggest that renal dysfunction that occurs in a certain proportion of patients (9.6%) is not associated with exposure to the virus. Complications are usually explained by old age, concomitant chronic diseases and an inadequate response of the immune system to SARS-CoV-2 – an excessive inflammatory response. In other words, in people under the age of 65, who do not have a bouquet of serious chronic diseases, it is extremely unlikely that the kidneys are disrupted due to coronavirus.
A scientific work describing the study and its results was published in one of the most prestigious urological journals in the world, Current Opinion in Urology. And this is a serious success for Russian scientists – only the most outstanding works are allowed to be published in journals of this level after strict peer review by independent experts.
COMMENT BY THE LEADER OF THE RESEARCH TEAM
Coronavirus does not cling to the surface of the kidneys
Dmitry Yenikeev, professor at the Institute of Urology and Human Reproductive Health at Sechenov University , answered the questions of Komsomolskaya Pravda .
- Dmitry Viktorovich, now it is often said that ACE receptors through which the coronavirus enters our body are present in almost all organs. And therefore, the causative agent of covid penetrates almost everywhere. Is there no such receptor in the kidneys? Or how, in your opinion, can you explain the fact that SARS-CoV-2 does not impair kidney function?
- ACE-2 receptors are also present in the kidneys. However, scientists often forget that almost all of these receptors are located deep in the kidney tissue, which is not in direct contact with blood – in the kidney tubules. The virus can get there only if the kidney apparatus itself, which purifies the blood, is damaged by inflammation . This explains why, in our work, serious renal impairments were noted only in patients with a severe stage of the disease.
- You can often hear that now the problem of covid-associated nephritis (inflammatory kidney disease) is being raised in full growth. But is this really so often found, or is it more of an exaggeration from the series “fear has big eyes”?
- According to a large literature review published in the English scientific journal BMC Nephrology , impaired renal function occurs in 7-10% of cases, mainly in patients with severe disease.
It is important to remember that impaired renal function is possible, but in the overwhelming majority of cases this occurs precisely in patients of a certain category. That is, elderly people and / or patients who already have cardiovascular and renal pathologies at the time of infection with covid. We noticed the same pattern during our own research.
- What role can the results of your research play? Is it possible, on their basis, to somehow adjust the treatment of covid, to assess the prospects of the sick?
- I would like to emphasize that it is important to correctly interpret the results of our work. Renal impairment is possible in patients with COVID-19, but only the most severely ill will experience serious damage that will require correction. One should be prepared that disorders of this kind develop in about 10% of patients, and about half of them may require hemodialysis.