Since the beginning of the coronavirus pandemic, physicians worldwide have complained about the lack of artificial lung ventilators, as the virus mainly affects the respiratory system and in severe cases penetrates the lungs, causing respiratory failure.
Recently, however, doctors in the United States and China have noticed a sharp increase in the number of people with kidney failure among those infected. As a result, hospitals are already experiencing severe shortages of hemodialysis machines (artificial kidneys) and medical personnel trained to treat such patients, not to mention the necessary medications.
Because the new virus is still very poorly understood, it is impossible to say for sure whether it directly affects the kidneys or whether it is just a side effect of the infection. It is known that people who already have health problems and related illnesses tend to experience Covid-19 more severely than others. Many patients may simply not be aware that they have kidney problems. However, it cannot be excluded that it is an overactivation of the immune system: when it detects an unknown infection, it begins to attack not only the virus itself, but also healthy cells of the own organism, including such a sensitive organ as the kidneys.
According to one version, infected individuals are more likely to develop blood clots in their blood vessels, which in turn can negatively affect the kidneys, which are permeated by a network of tiny capillaries. It is also known that the kidneys are closely connected to the liver and the bladder. And now many doctors are concerned that if patients with Covid-19 have kidney problems, it is possible that in the near future a wave of complications may occur in the related organs as well.
For now, these are all theories, although the experience of several previous epidemics shows that healthcare workers should be prepared for the most unexpected scenarios of infection development. Nowadays, doctors in many hospitals have to decide which patients should be connected to hemodialysis machines and in which order, because there are not enough “artificial kidneys” for everyone. In other words, only those with a higher chance of survival are saved – more seriously ill patients may be left to die without the help they need. The acute shortage of trained dialysis nurses further exacerbates the situation.
According to the latest data from American doctors, 20 to 40% of all patients admitted to intensive care with coronavirus suffer from severe kidney dysfunction, and all of them require hemodialysis, writes the New York Times. This has already led to a shortage of both the “artificial kidney” devices themselves and the drugs needed for the procedure, as no one anticipated such a sharp increase in the number of patients needing this procedure. According to Dr. Barbara Murphy of the American network of Mount Sinai hospitals, the number of patients in acute need of hemodialysis has tripled at just one clinic. In the United States, only two major companies produce “artificial kidney” devices and all the materials needed to make them. Both companies report that demand for their products has increased fivefold – not only in America, but also in China and European countries.
There is a worldwide shortage of these devices that help the kidneys function. In some New York hospitals, doctors are forced to resort to a less effective and riskier method of blood purification – peritoneal dialysis. It is usually used for milder kidney disease, but doctors say it is better than nothing.
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Scientists are beginning to understand which specific organs the new coronavirus affects and how it does so. In the early 2000s, the “atypical pneumonia” epidemic known as SARS spread to thirty countries. At the time, scientists discovered that the causative agent of the disease, the SARS-CoV virus, enters human cells with the help of two proteins: the ACE2 cell receptor and the TMPRSS2 enzyme. Now it has been shown that infection with the SARS-CoV-2 virus, which causes Covid-19, occurs in much the same way – and this gives scientists a clue as to which organs are most at risk. Specifically, the respiratory tract, the intestines, and presumably the kidneys, because they contain the two proteins needed by the virus.
In addition, health systems in many countries have learned lessons from the HIV epidemic that began in the early 1980s. For a long time it was believed that HIV only threatened homosexual men, people who had received blood transfusions, and people of Haitian descent. But after white, heterosexual, affluent women started dying of AIDS, the authorities became alarmed and urgently changed the rules for testing new drugs and medicines – so that in extreme situations like an epidemic, it could be done quickly, literally within months, not years. The same is happening now. Quarantines are in place almost everywhere, and enormous efforts are being made to find a vaccine and specific drugs for the new coronavirus. Human trials of some vaccine prototypes have already begun. But developing a vaccine, let alone a drug, for coronavirus can take a long time. It is possible that over time Covid-19 will simply become a chronic disease that can be controlled.