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COVID-19 outcomes in patients with a history of immune-mediated glomerular diseases
Med Univ Innsbruck, Austria.
Univ Innsbruck, Austria.
Johns Hopkins Univ, MD USA.
Univ Cambridge, England; Med Univ Graz, Austria.
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2023 (English)In: Frontiers in Immunology, E-ISSN 1664-3224, Vol. 14, article id 1228457Article in journal (Refereed) Published
Abstract [en]

Introduction: Patients with immune-mediated glomerular diseases are considered at high risk for severe COVID-19 outcomes. However, conclusive evidence for this patient population is scarce.Methods: We created a global registry and retrospectively collected clinical data of patients with COVID-19 and a previously diagnosed immune-mediated glomerular disease to characterize specific risk factors for severe COVID-19 outcomes.Results: Fifty-nine patients with a history of immune-mediated glomerular diseases were diagnosed with COVID-19 between 01.03.2020 and 31.08.2021. Over a mean follow-up period of 24.79 +/- 18.89 days, ten patients (16.9%) developed acute kidney injury. Overall, 44.1% of patients were managed in an outpatient setting and therefore considered as having "non-severe" COVID-19, while 55.9% of patients had severe COVID-19 requiring hospitalization including worse outcomes. Comparing both groups, patients with severe COVID-19 were significantly older (53.55 +/- 17.91 versus 39.77 +/- 14.95 years, p = .003), had lower serum albumin levels at presentation (3.00 +/- 0.80 g/dL versus 3.99 +/- 0.68 g/dL, p = .016) and had a higher risk of developing acute kidney injury (27% versus 4%, p = .018). Male sex (p <.001) and ongoing intake of corticosteroids at presentation (p = .047) were also significantly associated with severe COVID-19 outcomes, while the overall use of ongoing immunosuppressive agents and glomerular disease remission status showed no significant association with the severity of COVID-19 (p = .430 and p = .326, respectively).Conclusion: Older age, male sex, ongoing intake of corticosteroids and lower serum albumin levels at presentation were identified as risk factors for severe COVID-19 outcomes in patients with a history of various immune-mediated glomerular diseases.

Place, publisher, year, edition, pages
FRONTIERS MEDIA SA , 2023. Vol. 14, article id 1228457
Keywords [en]
coronavirus; risk factor; autoimmune disease; kidney disease; glomerulonephritis; immunosuppression
National Category
Microbiology in the medical area
Identifiers
URN: urn:nbn:se:liu:diva-198507DOI: 10.3389/fimmu.2023.1228457ISI: 001071707200001PubMedID: 37767096OAI: oai:DiVA.org:liu-198507DiVA, id: diva2:1805420
Note

Funding Agencies|The authors thank Lalit Kaltenbach for his support with the creation and administration of the REDCap database.

Available from: 2023-10-17 Created: 2023-10-17 Last updated: 2024-05-03

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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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