Fears Covid may leave thousands in UK with severe kidney disease | World news

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Tens of thousands of people may require kidney dialysis or transplants because of coronavirus, according to experts who warn the long-term effects of Covid are causing an “epidemic in primary care”.

Up to 90% of coronavirus patients admitted to hospital may still experience symptoms two to three months later – from breathlessness to joint pain, fatigue and chest pain – scientists told the Lords science and technology committee on Tuesday.

Donal O’Donoghue, a consultant renal physician at Salford Royal NHS trust, said damage to the kidneys was of major concern. It is believed the virus may attack the organ directly, he said, while the kidneys could also be injured by body-wide inflammation caused by the virus.

“Normally we see maybe 20% of people that go onto intensive care unit need to have a form of dialysis. During Covid it was up to 40% – and 85% of people had some degree of kidney injury,” he said. “No doubt that is happening out in the community as well, probably to a lesser extent.”


O’Donoghue said it was unknown how many of these patients would go on to develop more severe kidney disease, but that the figures could be high. “It could easily be tens of thousands more people requiring dialysis [or] transplantation,” he said, adding that in a normal year about 6,500 people were accepted on to dialysis and transplant programmes.

Tom Solomon, professor of neurology at the University of Liverpool, told the committee that more needed to be done to support Covid survivors. “[GPs] are seeing lots of patients who are left over with problems from their Covid and they need to be able to refer them to get help in understanding what is going on,” he said, adding: “This is really the current epidemic in primary care.”

Chris Brightling, professor of respiratory medicine of the University of Leicester who is leading the Phosp-Covid study into the long-term effects of the disease, said research in Italy had given further clues as to the scale of the virus’s lasting effects.

“This suggested even when you are looking at people who have been hospitalised two to three months later, after discharge, then only about 10-15% of people have no persistent symptoms,” he said.

Brightling said pilot data from whole body scans of 50 patients who are part of the Phos-Covid and C-MORE studies were revealing the wider physiological impact of Covid-19.

“[These] are showing end-organ damage in the kidneys, in the liver, in the lungs and in the heart, and less so in the brain. This is affecting over a third of the individuals at the two month point,” he said. “We are really getting a lot of clues that there are things that are happening across multiple organs from a disease that initially starts as a respiratory infection.”

While much of the current research is based on those who have been admitted to hospital with Covid-19, Brightling warned long term effects, in particular problems like fatigue and chronic pain, were likely in those who had a “milder” form of the disease.

“Some of those may have also had pneumonia and not ended up in hospital, but many may have had this more broader inflammatory effect that may then affect many, many organs in the body,” he said.

Brightling added that a key issue was whether some conditions may get worse over time, such as early kidney damage or onset of new diabetes. “That definitely would be a concern within those people who are in the community,” he said.

Experts giving evidence to the committee also highlighted that the impact of Covid on the body could cause neurological problems, including stroke and brain inflammation. The disease has also been linked to mental health problems, both in those with the disease and those without.

Sebastian Brandner, professor of neuropathology at University College London, said more autopsies were needed to understand how the disease affects the central nervous system.

If a patient is known to have died from Covid, a coroner’s autopsy is generally not required. However, autopsies can be carried out for medical research if consent is given by the deceased’s family.

“During this entire Covid-19 outbreak we had only just over a dozen, or perhaps two dozen, postmortems with available brains for analysis,” said Brandner, something he suggested was down to a reluctance by NHS hospitals because of resources being diverted to treatment and management of patients.

With resources readjusted and mortuaries not overwhelmed, Brandner said it was important such research was now carried out.

Source: The Guardian
Keyword: Fears Covid may leave thousands in UK with severe kidney disease | World news

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