Covid-19 is a type (strain) of coronavirus. A virus is a very tiny germ that can cause an infection and can only replicate in a living host (humans or animals). When we say tiny, this new coronavirus is 80-140 nanometre in diameter. A normal ball pen tip is about 1mm in diameter. About 1.7crore to 3.9 crores of this virus can be comfortably accommodated on the tip of it. Coronaviruses are a group (or family) of viruses that cause different illnesses. These illnesses can range from the common cold to more severe diseases, such as Severe Acute Respiratory Syndrome (SARS).
The disease caused by this virus has different names, one of them being Covid-19 – Coronavirus Disease 2019 for the year in which it first appeared globally. Covid-19 is also known as “novel coronavirus,” meaning a new type of coronavirus not previously discovered or identified. Covid-19 is also called SARS-Cov-2 for severe acute respiratory syndrome coronavirus 2.
Covid -19 is a new virus to which no one has immunity. Its average mortality is about 3.4%, which is lesser than other corona viral diseases like SARS and MERS. However, it is highly contagious and spreads through contact and /or even air, as per recent studies. Persons who are in contact with Covid -19 patients/asymptomatic carriers are more prone to get infections
Which is the population at risk?
The following groups are more at risk for Covid-19:
Individuals with a kidney transplant and taking immunosuppressant medicines may also be at a higher risk.
Coronavirus and Acute kidney damage
Detecting proteins and/or blood in urine is an early sign of kidney involvement in people with confirmed Covid-19. Approximately 3% to 9% of patients with confirmed Covid-19 develop acute kidney failure, with many requiring dialysis treatment. Regardless of age, people with AKI (acute kidney injury) have poor outcome. It has been recommended that recovered Covid-19 patients who had an AKI should be seen regularly by a kidney doctor because their risk of developing chronic kidney disease is higher than others. Covid-19 patients who did not develop an AKI, but who had blood and/or protein in their urine should be monitored since they are at increased risk of developing chronic kidney disease.
2) For patients with kidney disease
Isolation has to be complete (i.e. no face to face contact or physical proximity with anyone, including members of the family inside the house) and prolonged (12 weeks or more) in case one belongs to any of the groups mentioned below:
I] Precautions for patients with chronic kidney disease
COVID-19 is a new virus and therefore research on it has only just begun. Leading health organisations such as the World Health Organization (WHO) and the Centre for Disease Control and Prevention (CDC) have not recommended that patients stop any particular drug in order to decrease the chance of getting COVID-19 or to make it less severe.
Blood pressure medications called angiotensin converting enzyme inhibitors (ACEs) and angiotensin receptor blockers (ARBs) should NOT be stopped, unless recommended by a healthcare professional. These are key drugs in controlling blood pressure in patients with kidney disease. Stopping them could lead to a heart attack, stroke or decreased kidney function.
Patients with kidney transplants should not stop taking their immunosuppressants or lower their dose, unless their healthcare team tells them to. Stopping the immunosuppressants will most likely lead to loss of the donated kidney. The transplant team should be contacted for any questions or concerns.
Patients with kidney disease are usually told to avoid non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. In general, kidney experts recommend acetaminophen for pain relief and reducing fever. The healthcare team should be consulted before making any changes in the drugs being regularly taken.
II] Recommendations for patients on hemodialysis
Is there any treatment for covid 19?
Presently there is no definitive treatment available for this virus. There are few antimicrobials with potential activity against SARS-CoV-2 such as Hydroxychloroquin, Chloroquin, Lopinavir, Remdisivir and Faviperavir. Some compounds are adjunctive or for supportive care such as Azithromycin, Immunomodulating agents, COVID-19 convalescent plasma, Anticoagulation, and interleukins like Tocilizumab, & Sarilumab. Apart from this, detailed research is ongoing rapidly in several countries in developing a successful vaccine. Plasma therapy and stem cell work are also being followed extensively.
In conclusion, coronavirus is a novel virus which spreads very rapidly in the community with 3-5% mortality and presently we do not have any definite treatment or vaccine. Mortality goes upto 15-20% in elderly population, patients with poor immunity due to underlying illness like kidney, disease. Since there is no way to fight this deadly virus, the only option is to maintain social distancing, self-hygiene and educating one and all around.
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