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Front Immunol . COVID-19 outcomes in patients with a history of immune-mediated glomerular diseases

tetano

Editor, Senior Moderator
Front Immunol


. 2023 Sep 12;14:1228457.
doi: 10.3389/fimmu.2023.1228457. eCollection 2023. COVID-19 outcomes in patients with a history of immune-mediated glomerular diseases

Philipp Gauckler[SUP] 1 [/SUP], Jana S Kesenheimer[SUP] 2 [/SUP], Duvuru Geetha[SUP] 3 [/SUP], Balazs Odler[SUP] 4 5 [/SUP], Kathrin Eller[SUP] 5 [/SUP], Timothee Laboux[SUP] 6 7 [/SUP], Federico Alberici[SUP] 8 [/SUP], Mattia Zappa[SUP] 8 [/SUP], Natasha Chebotareva[SUP] 9 [/SUP], Sergey Moiseev[SUP] 9 [/SUP], Marco Bonilla[SUP] 10 [/SUP], Kenar D Jhaveri[SUP] 10 [/SUP], Julie Oniszczuk[SUP] 11 [/SUP], Vincent Audard[SUP] 11 [/SUP], Denise Costa[SUP] 12 13 [/SUP], Gianna Mastroianni-Kirsztajn[SUP] 14 [/SUP], Annette Bruchfeld[SUP] 15 16 [/SUP], Masahiro Muto[SUP] 17 [/SUP], Martin Windpessl[SUP] 18 [/SUP], Gert Mayer[SUP] 1 [/SUP], Andreas Kronbichler[SUP] 1 4 [/SUP]



Affiliations
Abstract

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.

Keywords: autoimmune disease; coronavirus; glomerulonephritis; immunosuppression; kidney disease; risk factor.

 
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