Antibody levels in Covid-19

A study from China has shown that antibody levels decrease by approximately 70% by 8 weeks in both symptomatic and symptomatic Covid-19 infections. The study also showed that 40% of asymptomatic infections tested negative for IgG antibodies compared to 12.9% of symptomatic infections. Asymptomatic individuals also had lower pro- and anti-inflammatory cytokines, suggesting a weaker immune response towards Covid-19 compared to symptomatic individuals The steep decline in antibodies is an important finding because this may influence physical distancing measures as these patients could be at risk of re-infection.         

Reference 

Long, Q., Tang, X., Shi, Q. et al. Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections. Nat Med (2020). Published 18th June 2020

Kidney involvement in Covid-19

Proteinuria and haematuria are common in patients presenting with Covid-19. This was observed in a large study from China (1). 43.9% of patients with Covid-19 had proteinuria on admission and 26.7% had haematuria.   This is a fascinating finding. This could point to significant renal pathology in Covid-19. A small renal biopsy case series from North America was published this month (2). This case series showed a variety of glomerular and tubular pathologies in 17 Covid-19 patients presenting with nephrotic range proteinuria and acute kidney injury. None of the cases had evidence of direct viral infection in the kidney.  Knowledge in this area is evolving, and I await further articles with great interest. The articles referenced below will be of relevance to nephrologists worldwide.

References
1. Cheng Y, Luo R, Wang K et al. Kidney disease is associated with in-hospital death of patients with Covid-19  Kidney Int 2020; 97(5): 829-838     
2. Kudose S, Batal I, Santoriello D et al. Kidney biopsy findings in patients with Covid-19.  J Am Soc Nephrol 2020 (published online 17th July 2020)

The crown that lasts

These verses from the Bible encouraged me today

Do you not know that in a race all the runners run, but only one gets the prize?  Run in such a way as to get the prize. Everyone who competes in the games goes into strict training. They do it to get a crown that will not last, but we do it to get a crown that will last forever.

 1 Corinthians 9:24-25

We are truly running an incredible race.