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COVID-19 in Patients with Glomerular Disease: Follow-Up Results from the IRoc-GN International Registry
NIDDK, MD 20892 USA.
Hosp Univ Vall dHebron, Spain; Vall dHebron Hosp Univ, Spain.
Hosp Univ Vall dHebron, Spain; Vall dHebron Hosp Univ, Spain.
Imperial Coll London, England; Imperial Coll Healthcare NHS Trust Renal & Transp, England.
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2022 (English)In: KIDNEY360, ISSN 2641-7650, Vol. 3, no 2, p. 293-306Article in journal (Refereed) Published
Abstract [en]

Background The acute and long-term effects of severe acute respiratory syndrome coronavirus 2 infection in individuals with GN are still unclear. To address this relevant issue, we created the International Registry of COVID-19 infection in GN.Methods We collected serial information on kidney-related and-unrelated outcomes from 125 GN patients (63 hospitalized and 62 outpatients) and 83 non-GN hospitalized patients with coronavirus disease 2019 (COVID-19) and a median follow-up period of 6.4 (interquartile range 2.3-9.6) months after diagnosis. We used logistic regression for the analyses of clinical outcomes and linear mixed models for the longitudinal analyses of eGFR. All multiple regression models were adjusted for age, sex, ethnicity, and renin-angiotensin-aldosterone system inhibitor use.Results After adjustment for pre-COVID-19 eGFR and other confounders, mortality and AKI did not differ between GN patients and controls (adjusted odds ratio for AKI=1.28; 95% confidence interval [CI], 0.46 to 3.60; P=0.64). The main predictor of AKI was pre-COVID-19 eGFR (adjusted odds ratio per 1 SD unit decrease in eGFR=3.04; 95% CI, 1.76 to 5.28; P,0.001). GN patients developing AKI were less likely to recover pre-COVID19 eGFR compared with controls (adjusted 6-month post-COVID-19 eGFR=0.41; 95% CI, 0.25 to 0.56; times preCOVID-19 eGFR). Shorter duration of GN diagnosis, higher pre-COVID-19 proteinuria, and diagnosis of focal segmental glomerulosclerosis or minimal change disease were associated with a lower post-COVID-19 eGFR.Conclusions Pre-COVID-19 eGFR is the main risk factor for AKI regardless of GN diagnosis. However, GN patients are at higher risk of impaired eGFR recovery after COVID-19-associated AKI. These patients (especially those with high baseline proteinuria or a diagnosis of focal segmental glomerulosclerosis or minimal change disease) should be closely monitored not only during the acute phases of COVID-19 but also after its resolution.

Place, publisher, year, edition, pages
AMER SOC NEPHROLOGY , 2022. Vol. 3, no 2, p. 293-306
Keywords [en]
glomerular and tubulointerstitial diseases; COVID-19; follow-up studies; glomerular disease; kidney glomerulus; registries
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-193521DOI: 10.34067/KID.0006612021ISI: 000913726700015PubMedID: 35373130OAI: oai:DiVA.org:liu-193521DiVA, id: diva2:1754337
Note

Funding Agencies|Intramural Research Program of the NIH; National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London; NIH R01; [DK119431]; [AI132949]

Available from: 2023-05-03 Created: 2023-05-03 Last updated: 2023-05-03

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Bruchfeld, Annette

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Division of Diagnostics and Specialist MedicineFaculty of Medicine and Health SciencesDepartment of Nephrology
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