Covid‐19, ACE2 and the kidney

Covid-19, ACE2 and the kidneyWe are confronted with the most dramatic pandemic worldwide in the past 100 years.We are armed "to-the-teeth" compared to 1918, we know the agent, the genomic sequence, the bodily entry, the proliferation rate, the damage pathogenesis and the very nature of our enemy.We can identify its bodily presence and our resistance to it in terms of neutralizing antibody production.Nonetheless, the disease has laid lame the great nations of the current world and crippled the less fortunate countries.The primary disease features are not the kidney.However, the entry point has much to do with renal and cardiovascular disease.The kidney is a common target of corona-virus (SARS-CoV2) disease; the longer-term consequences could be as well.Corona-virus disease 2019 (Covid-19) is a global pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Corona viruses are RNA viruses.Coronavirus attention was drawn through the severe acute respiratory syndrome (SARS), a viral respiratory disease of zoonotic origin caused by SARS-CoV1.The Middle East respiratory syndrome (MERS), also known as camel flu, is a viral respiratory infection caused by a similar MERS-coronavirus (MERS-CoV).SARS and MERS thankfully did not result in a pandemic, while SARS-CoV-2 unfortunately did.Thanks to molecular biology, much is known about these pathogens and because of indefatigable work by basic scientists and clinicians, our knowledge of the disease entities is also quite complete.This state-of-affairs is not new.Over 100 years ago, we faced a quite similar pandemic, the outcome of which is still not clear.At least in the realm of literature, that epidemic yielded a Nobel prize in literature (Sinclair Lewis).Can the history of Arrowsmith help us further? 1 Corona viruses are known since 1930 and were first identified in fowl.The name is garnered from the roughly spherical-shaped particles that exhibit bulbous surface projections, particularly the spike proteins.Human corona viruses infect the epithelial cells of the respiratory tract.Drosten et al identified a novel corona virus in patients with SARS (SARS-Co-V).2 Their findings and those of others showed that novel corona viruses cause SARS.Fortunately, the SARS scare abated, albeit with serious reservations.3 Next came MERS.Similarly, MERS also failed to cause a pandemic.Obviously, Covid-19 disease is something quite different.4,5