Kidney outcome after mild to moderate COVID-19.
CKD
COVID-19
SARS-CoV-2
kidney
sequela
Journal
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
ISSN: 1460-2385
Titre abrégé: Nephrol Dial Transplant
Pays: England
ID NLM: 8706402
Informations de publication
Date de publication:
31 08 2023
31 08 2023
Historique:
received:
25
09
2022
medline:
1
9
2023
pubmed:
20
1
2023
entrez:
19
1
2023
Statut:
ppublish
Résumé
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a remarkable kidney tropism. While kidney effects are common in severe coronavirus disease 2019 (COVID-19), data on non-severe courses are limited. Here we provide a multilevel analysis of kidney outcomes after non-severe COVID-19 to test for eventual kidney sequela. This cross-sectional study investigates individuals after COVID-19 and matched controls recruited from the Hamburg City Health Study (HCHS) and its COVID-19 program. The HCHS is a prospective population-based cohort study within the city of Hamburg, Germany. During the COVID-19 pandemic the study additionally recruited subjects after polymerase chain reaction-confirmed SARS-CoV-2 infections. Matching was performed by age, sex and education. Main outcomes were estimated glomerular filtration rate (eGFR), albuminuria, Dickkopf3, haematuria and pyuria. A total of 443 subjects in a median of 9 months after non-severe COVID-19 were compared with 1328 non-COVID-19 subjects. The mean eGFR was mildly lower in post-COVID-19 than non-COVID-19 subjects, even after adjusting for known risk factors {β = -1.84 [95% confidence interval (CI) -3.16 to -0.52]}. However, chronic kidney disease [odds ratio (OR) 0.90 (95% CI 0.48-1.66)] or severely increased albuminuria [OR 0.76 (95% CI 0.49-1.09)] equally occurred in post-COVID-19 and non-COVID-19 subjects. Haematuria, pyuria and proteinuria were also similar between the two cohorts, suggesting no ongoing kidney injury after non-severe COVID-19. Further, Dickkopf3 was not increased in the post-COVID-19 cohort, indicating no systematic risk for ongoing GFR decline [β = -72.19 (95% CI -130.0 to -14.4)]. While mean eGFR was slightly lower in subjects after non-severe COVID-19, there was no evidence for ongoing or progressive kidney sequela.
Sections du résumé
BACKGROUND
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a remarkable kidney tropism. While kidney effects are common in severe coronavirus disease 2019 (COVID-19), data on non-severe courses are limited. Here we provide a multilevel analysis of kidney outcomes after non-severe COVID-19 to test for eventual kidney sequela.
METHODS
This cross-sectional study investigates individuals after COVID-19 and matched controls recruited from the Hamburg City Health Study (HCHS) and its COVID-19 program. The HCHS is a prospective population-based cohort study within the city of Hamburg, Germany. During the COVID-19 pandemic the study additionally recruited subjects after polymerase chain reaction-confirmed SARS-CoV-2 infections. Matching was performed by age, sex and education. Main outcomes were estimated glomerular filtration rate (eGFR), albuminuria, Dickkopf3, haematuria and pyuria.
RESULTS
A total of 443 subjects in a median of 9 months after non-severe COVID-19 were compared with 1328 non-COVID-19 subjects. The mean eGFR was mildly lower in post-COVID-19 than non-COVID-19 subjects, even after adjusting for known risk factors {β = -1.84 [95% confidence interval (CI) -3.16 to -0.52]}. However, chronic kidney disease [odds ratio (OR) 0.90 (95% CI 0.48-1.66)] or severely increased albuminuria [OR 0.76 (95% CI 0.49-1.09)] equally occurred in post-COVID-19 and non-COVID-19 subjects. Haematuria, pyuria and proteinuria were also similar between the two cohorts, suggesting no ongoing kidney injury after non-severe COVID-19. Further, Dickkopf3 was not increased in the post-COVID-19 cohort, indicating no systematic risk for ongoing GFR decline [β = -72.19 (95% CI -130.0 to -14.4)].
CONCLUSION
While mean eGFR was slightly lower in subjects after non-severe COVID-19, there was no evidence for ongoing or progressive kidney sequela.
Identifiants
pubmed: 36657383
pii: 6993076
doi: 10.1093/ndt/gfad008
pmc: PMC10468748
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2031-2040Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.
Références
N Engl J Med. 2020 Oct 8;383(15):1436-1446
pubmed: 32970396
Kidney Int. 2020 May;97(5):829-838
pubmed: 32247631
Nat Metab. 2022 Mar;4(3):310-319
pubmed: 35347318
Lancet. 2019 Aug 10;394(10197):488-496
pubmed: 31202596
Am J Kidney Dis. 2021 Apr;77(4):490-499.e1
pubmed: 33422598
Lancet Infect Dis. 2020 Aug;20(8):920-928
pubmed: 32422201
Nat Med. 2020 Jul;26(7):1017-1032
pubmed: 32651579
Nat Med. 2022 Mar;28(3):583-590
pubmed: 35132265
Nat Rev Nephrol. 2017 Apr;13(4):241-257
pubmed: 28239173
Kidney Int. 2011 Jul;80(1):17-28
pubmed: 21150873
Eur Heart J. 2022 Mar 14;43(11):1124-1137
pubmed: 34999762
J Am Soc Nephrol. 2021 Nov;32(11):2851-2862
pubmed: 34470828
Lancet. 2020 Aug 29;396(10251):597-598
pubmed: 32818439
N Engl J Med. 2020 Aug 6;383(6):590-592
pubmed: 32402155
JCI Insight. 2016 Jan 21;1(1):e84916
pubmed: 27699213
Kidney Int. 2021 Nov;100(5):1081-1091
pubmed: 34237325
J Am Soc Nephrol. 2021 Jan;32(1):151-160
pubmed: 32883700
Lancet. 2021 Jan 16;397(10270):220-232
pubmed: 33428867
J Am Soc Nephrol. 2018 Nov;29(11):2722-2733
pubmed: 30279273
Bioinformatics. 2012 Jan 1;28(1):112-8
pubmed: 22039212
Eur J Epidemiol. 2020 Feb;35(2):169-181
pubmed: 31705407
Cell Stem Cell. 2022 Feb 3;29(2):217-231.e8
pubmed: 35032430
Nephrol Dial Transplant. 2021 Nov 9;36(11):2143-2147
pubmed: 34373917
J Clin Med. 2021 Jul 09;10(14):
pubmed: 34300217
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
MMWR Morb Mortal Wkly Rep. 2020 Jun 19;69(24):759-765
pubmed: 32555134
Ann Intern Med. 2013 Jun 4;158(11):825-30
pubmed: 23732715