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Virus Res
. 2020 May 20;198034.
doi: 10.1016/j.virusres.2020.198034. Online ahead of print.
Sodium Status and Kidney Involvement During COVID-19 Infection
Adrian Post 1 , Robin P F Dullaart 2 , Stephan J L Bakker 3
Affiliations
- PMID: 32445872
- DOI: 10.1016/j.virusres.2020.198034
Abstract
The angiotensin-converting enzyme 2 receptor (ACE2) is expressed in epithelial cells of many tissues including the kidney, and has been identified to interact with human pathogenic coronaviruses, including SARS-CoV-2. Although diffuse alveolar damage and acute respiratory failure are the main features of COVID-19 infection, two recent studies demonstrate that kidney impairment in hospitalized COVID-19 patients is common, and that kidney involvement is associated with high risk of in-hospital death. Interestingly, studies in rats have demonstrated that high dietary sodium intake results in down-regulation of the ACE2 expression in kidney tissue. We hypothesize that low sodium status makes renal involvement during the course of COVID-19 infection more likely due to upregulation of membrane bound ACE2 in the kidneys. We propose that sodium intake and status should be monitored carefully during severe COVID-19 infections, and that low sodium intake be corrected early in its course, despite a potential conflict regarding common dietary recommendations to restrict dietary sodium intake in patients with hypertension, diabetes, and kidney disease.
Copyright ? 2020. Published by Elsevier B.V.