COVID-19: Kidney Injury Links, Fewer Myocardial Infarction Hospitalization, and More
From acute kidney injury to children with ADHD, here's the latest research and discussions around the pandemic's effect on other specialties.
Here’s a look at some of the biggest headlines on coronavirus 2019 (COVID-19) comorbidity research and discussion from this last week, courtesy of our sister publication HCPLive®:
A team from the University of Michigan found the urokinase receptor system could be a key regulation between inflammation, immunity, and coagulation, while the soluble urokinase plasminogen activator receptor (suPAR) has been identified as an immunologic risk factor for acute kidney injuries (AKIs).
However, researchers do not know whether suPAR is linked with COVID-19-related AKI.
“Admission suPAR levels in patients hospitalized for COVID-19 are predictive of in-hospital AKI and the need for dialysis,” the authors wrote. “SuPAR may be a key component of the pathophysiology of AKI in COVID-19.”
Ankit Bharat, MD, chief of thoracic surgery and surgical director for the program, shared the incredible story of the first double lung transplant for a severely ill US patient with COVID-19 with HCPLive last month.
Though the successful transplant set a precedent for COVID-19 care, Bharat also sees it helping to confront another great US public health issue: the underutilization of donor lungs.
“Only 15% of all the lungs coming from donors get utilized,” he explained. “We have a huge opportunity to understand donor management and improve the utilization of those lungs.”
Approximately 2700 lung transplants were performed in the US last year, Bharat said—with many more opportunities for procedures left unanswered, and an even greater count of donor lungs expired.
Along with showing capability to better a respiratory distress-generating disease like COVID-19, surgeons have become capable of safely transplanting hepatitis C patient donor lungs—a previously taboo practice—as well as using ex vivo lung perfusion circuits to give second life to donor lungs.
“We certainly hope with the success we’ve had, and other centers on the east coast and west coast similarly performing these transplants and getting these patients through, the OPTN (Organ Procurement and Transplantation Network) includes COVID-19 as a diagnosis code in their registration of these recipients,” Bharat said.
A DocTalk podcast interview with Theresa Cerulli, MD, a psychiatrist and lecturer at Beth Israel Deaconess Medical Center, shared how the pandemic-affected school year may be particularly burdensome for patients with ADHD.
The introduction of virtual learning and public health-centric parameters being introduced to young students can present a series of challenges for those with ADHD, she explained—not to mention the likely cancellation of vital extracurricular activities.
On the podcast, Cerulli discussed things teachers and parents should watch for and help with in order to reduce some of the ADHD symptoms should children become frustrated. She also touched on some glimmers of hope in the field: new drugs in development she believes will really have an impact treating pediatric and adult ADHD patients.
Recent data from the ongoing French Cohort of Myocardial Infarction Evaluation (FRENCHIE) registry revealed hospital admission declines for acute myocardial infarction (AMI) in the time after pandemic lockdowns began.
The French investigators wrote the decrease should now encourage greater public health messaging on appropriate use of health services during the pandemic—namely, that one of the greatest factors of AMI survival is timely response.
“This is crucial in countries still fighting COVID-19, but also in the case of a second wave in countries that are past the first wave of the pandemic, or in case another pandemic occurs in the future,” they wrote.
The investigators collected data over an eight-week period, which covered 4 weeks preceding lockdown and 4 weeks following it.
Overall admission decreased from 686 to 481 between the periods—or by 30%. Furthermore, admissions for STEMI decreased by 24and admissions for NSTEMI decreased by 35%.