CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 09/6/2021

CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 09/6/2021

SEPT 5 KIDNEY ARTICLE FOR LONG HAULERS AND GOODBY MILTON

HELLO

HOPKINS CITATION:

1. COVID Long-haulers May Be At Risk for Severe Kidney Disease (CIDRAP) COVID-19 long-haulers—even those who experienced mild cases—are at significantly increased risk for substantial declines in kidney function, such as organ damage and chronic and end-stage kidney disease (ESKD), according to a study today in the Journal of the American Society of Nephrology.4.

THE ARTICLE ITSELF FROM THE AMERICAN JOURNAL OF NEPHROLOGY:

Kidney Outcomes in Long COVID (summary and access to PDA copy of the 71 page medical article with many elegant charts)

(J. Harris:  This is an important article concerning VA patients — about 89000 with Covid, 1.7 million vets without Covid. I humbly attach my attempts at an understandable and readable summary of this study, which has profound implications for millions of people as well as for potentially massive future health care costs due to increased numbers of patients worldwide who are likely to develop chronic renal failure. The abbreviations are not mine, but I tried to label them.)

HARRIS SUMMARY OF VA LONG HAUL KIDNEY STUDY

‘’…..In this work, we characterize post-acute kidney outcomes in a cohort of 89,216 30-day survivors of COVID-19. The results show that beyond [after] the first 30 days of infection, COVID-19 survivors exhibited increased risk (and burden) of AKI [ACUTE KIDNEY INJURY], eGFR [GLOMERULAR FILTRATION RATE, A MEASURE OF KIDNEY FUNCTION] decline, ESKD [END STAGE KIDNEY DISEASE], and MAKE [MAJOR ADVERSE KIDNEY EVENTS]. The risks (and burdens) of kidney outcomes increased according to the severity of the acute infection. While AKI during the acute phase contributed to the increased… COVID-19 should involve attention and care for acute and chronic kidney disease…… Examination of intra- individual longitudinal change in eGFR suggested that COVID-19 survivors experienced greater loss of eGFR than non-infected controls and that eGFR loss was more profound as the severity of the acute COVID-19 infection increased. Taken together, these results suggest that beyond the acute phase of COVID-19 infection, people with COVID-19 experience higher risk adverse kidney outcomes… Post-acute care of [these kidney damaged] people …highlights the need for integration of kidney care as a component of the multidisciplinary post-acute COVID… The implications of our findings are clear. Given the large number of people infected with COVID-19 (>34 million people in the US, and > 193 million globally), and given that estimates by the World Health Organization suggest that 10% of people infected with COVID-19 may experience post-acute sequelae, the numbers of people with long COVID in need of post COVID care will likely be staggering and will present substantial strain on already overwhelmed health systems. Governments and health systems around the world are establishing post-acute COVID clinics to attend to the needs of people with post-acute COVID sequelae. The optimal composition of those clinics is not yet clear… In sum, we show that 30-survivors of COVID-19 exhibited higher risk of AKI, eGFR decline, ESKD, and MAKE than those not infected by COVID-19. Greater longitudinal eGFR loss was observed in COVID-19 survivors (compared to non-infected controls). The risk of adverse kidney outcomes increased according to the severity of the acute infection as proxied by the care setting (non-hospitalized, hospitalized, and admitted to intensive care). The totality of the evidence suggests that substantial risk of kidney outcomes in people with COVID-19 and highlights the need to integrate a kidney care component in post-acute COVID care pathways.

AUTHORS:

Bowe, Benjamin; VA Saint Louis Health Care System Clinical Epidemiology Center, Research and Development Service; Saint Louis University College for Public Health and Social Justice, Department of Epidemiology and Biostatistics; Veterans Research and Education Foundation of Saint Louis

Xie, Yan; VA Saint Louis Health Care System Clinical Epidemiology Center, Research and Development Service; Saint Louis University College for Public Health and Social Justice, Department of Epidemiology and Biostatistics; Veterans Research and Education Foundation of Saint Louis

Xu, Evan; VA Saint Louis Health Care System Clinical Epidemiology Center, Research and Development Service; Saint Louis University School of Medicine

Al-Aly, Ziyad; VA Saint Louis Health Care System Clinical Epidemiology Center, Research and Development Service; Veterans Research and Education Foundation of Saint Louis; Washington University School of Medicine in Saint Louis, Department of Medicine; Medicine Service, VA Saint Louis Health Care System, Department of Medicine.

A Message from Milton,

Milton asked me to let you know that he’s headed to the Valley for the winter, but hopes to visit our area again. He is considering enrolling at the famous school, Bishop Sycamore, in order to acquire a horticulture degree. He does not intend to participate in sports while in school….Later this year, when the woods and the ground get good and wet, the stalks that he left behind will be placed atop a massive funeral pyre and cremated. (See photo below) 

Milton said, however, that he will be unable to attend the ceremony, although he expects that the press will cover the ceremony in-depth…..Interestingly, an autopsy on the desiccated stalks that remained after he departed revealed that Milton actually had two separate stalks that grew independently (neither well) after he was rescued from the vicious Wild Boar attack that occurred shortly after he initially arrived…His parting words to me were” Speak softly and keep your hoe sharp.” Then with a farewell smile he whispered\”Okraaaaaaaaa.”

MILTON’S LAST STAND — ACCOMPANIED BY  MARY GOLD, HIS  LONG TIME COMPANION

MILTON’S STALKS CEREMONIAL PYRE, GUARDED BY A LARGE GERMAN SHEPHARD, LADY, WHO SWEARS THAT SHE NEVER DIGS IN THE GARDEN.

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