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An intubated patient inside a negative pressure room in the COVID-19 ICU at a hospital West in Joplin, Mo., on Aug. 3.
An intubated patient inside a negative pressure room in the COVID-19 ICU at a hospital West in Joplin, Mo., on Aug. 3. (Angus Mordant/Bloomberg)

Kidney damage is painless and silent, and it's the latest ailment to be identified afflicting a large swath of COVID-19 survivors.

Injury to the blood-filtering organ can occur among people who recover from the coronavirus at home, and escalates with the severity of COVID, a study found. Even non-hospitalized patients with no renal problems have almost a twofold higher risk of developing end-stage kidney disease, compared with someone who never had COVID.

The findings, reported Wednesday in the Journal of the American Society of Nephrology, highlight yet another pernicious burden of the pandemic that's sickened more than 200 million people globally.

The data show 7.8 extra people needing dialysis or a kidney transplant per 10,000 of these mild-to-moderate COVID patients.

"This is not a small number, if you multiply by the huge number of Americans and also globally who might be ending up with end-stage kidney disease," said Ziyad Al-Aly, director of the clinical epidemiology center at the Veterans Affairs St. Louis Health Care System in Missouri. "This is really huge, and it will literally shape our lives for probably the next decade or more."

Al-Aly, who led the study, and his colleagues in April mined data collected during the routine delivery of care from the Veterans Health Administration to document the cascade of debilitating effects that plague COVID survivors months after diagnosis, from blood clots, stroke, diabetes and breathing difficulties to heart, liver and kidney damage, depression, anxiety and memory loss.

Al-Aly's latest research compared the risks of kidney-related conditions in 89,216 VA users who survived COVID against more than 1.7 million counterparts without the pandemic disease.

"What's really problematic about kidney disease is that it's really silent, that it doesn't really manifest in pain or any other symptoms," said Al-Aly, who also works as a nephrologist.

Al-Aly and colleagues found non-hospitalized COVID patients have a 23% increased risk of suffering acute kidney injury within six months — a condition that impedes the removal of waste and toxins from the blood.

Doctors caring for COVID survivors must also be alert for a broad spectrum of kidney disease among these patients, according to Al-Aly.

"If this is really happening at a wider scale — and we think it is — it's just a matter of time before we see all of these people hitting the clinics, needing dialysis, needing transplantation that places a lot of burden on the patient himself or herself, and really is very costly to the health care system," he said.

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