The continuing adjustments in the COVID-19 landscape

In the ever-changing landscape of the COVID-19 pandemic, the global population must refocus daily to remain tuned in to the latest understandings about the virus.

Some of the most important observations involve new ways in which the virus affects patients.

Nicholas Selby, BMedSci, BMBS MRCP, DM, recently reported in the British Medical Journal (doi: https://doi.org/10.1136/bmj.m1963. Published 26 May 2020) that acute kidney injury may be another feature of COVID-19 that can increase patients’ risk of death.

The kidney can be affected in all stages of the virus and clinicians must be vigilant for risk factors. “Although our understanding is incomplete, a picture is emerging from case reports and autopsy series of COVID-19 specific causes of acute kidney injury,” he noted.

Selby, a professor of nephrology, Centre for Kidney Research and Innovation, University of Nottingham, UK, explained that that this acute insult to the kidney may be caused by volume depletion, multi-organ failure, viral infection leading directly to kidney tubular injury, thrombotic vascular processes, glomerulonephritis, or rhabdomyolysis.

The incidence of acute kidney injury can be reduced by optimal maintenance of patients’ fluids. This new wrinkle in the viral effects is especially important when considering that there is not yet a light at the end of the tunnel in this pandemic.

The data are staggering, with close to 8 million people having been confirmed as infected and nearly a half million deaths worldwide. In the United States alone, the CDC has been predicting from 118,000 to 143,000 cumulative COVID-19 deaths by the end of June 2020.

Some U.S. cities are already beginning to see new spikes in cases resulting from both the Memorial Day holiday and the recent protests of racism during which social distancing has not been maximally respected.