Long COVID: COVID-19 survivors at increased risk of kidney disease, study finds
USA: A recent study pointed out an increased risk of kidney outcomes in COVID-19 survivors during the post-acute phase of the disease. The findings of the study, published in the Journal of American Society of Nephrology, implies that COVID-19 care during the post-acute period should involve attention to kidney disease.
COVID-19 symptoms can sometimes persist for months even after recovery; COVID-19 is associated with increased risk of post-acute sequelae involving extrapulmonary and pulmonary organ systems -- called long COVID. However, there is no availability of detailed assessment of kidney outcomes in long COVID. To fill this knowledge gap, Benjamin Bowe, VA Saint Louis Health Care System Clinical Epidemiology Center, Saint Louis, United States, and colleagues aimed to determine the long-term kidny outcomes in COVID-19 outcomes.
For this purpose, the researchers designed a cohort study involving 1,726,683 US Veterans identified from March 01, 2020 to March 15, 2021 including 89,216 30-day COVID-19 survivors and 1,637,467 non-infected controls. They examined the risks of eGFR decline, AKI, ESKD, and major adverse kidney events (MAKE) defined as eGFR decline ≥50%, ESKD, or all-cause mortality.
Key findings of the study include:
- Beyond the acute illness, 30-day survivors of COVID-19 exhibited a higher risk of AKI (aHR=1.94), eGFR decline ≥30% (1.25), eGFR decline ≥40% (1.44), eGFR decline ≥50% (1.62), ESKD (2.96), and MAKE (1.66).
- There was a graded increase in risks of post-acute kidney outcomes according to the severity of the acute infection (whether patients were non-hospitalized, hospitalized, or admitted to intensive care).
- Compared to non-infected controls, 30-day COVID-19 survivors exhibited excess eGFR decline of -3.26, -5.20, and -7.69 mL/min/1.73m2/year in non-hospitalized, hospitalized, and those admitted to intensive care during the acute phase of COVID-19 infection.
Dr Bowe and the team concluded that "COVID-19 survivors exhibited an increased risk of kidney outcomes in the post-acute phase of the disease. Post-acute COVID-19 care should involve attention to kidney disease."
The study titled, "Kidney Outcomes in Long COVID," is published in the Journal of American Society of Nephrology.