tetano
Editor, Senior Moderator
Kidney360
. 2021 Dec 3;3(2):293-306.
doi: 10.34067/KID.0006612021. eCollection 2022 Feb 24.
COVID-19 in Patients with Glomerular Disease: Follow-Up Results from the IRoc-GN International Registry
Meryl Waldman[SUP] 1 [/SUP], Maria Jose Soler[SUP] 2 3 [/SUP], Clara García-Carro[SUP] 2 3 [/SUP], Liz Lightstone[SUP] 4 5 [/SUP], Tabitha Turner-Stokes[SUP] 4 5 [/SUP], Megan Griffith[SUP] 5 [/SUP], Joan Torras[SUP] 6 [/SUP], Laura Martinez Valenzuela[SUP] 6 [/SUP], Oriol Bestard[SUP] 2 3 [/SUP], Colin Geddes[SUP] 7 [/SUP], Oliver Flossmann[SUP] 8 [/SUP], Kelly L Budge[SUP] 9 [/SUP], Chiara Cantarelli[SUP] 10 [/SUP], Enrico Fiaccadori[SUP] 10 [/SUP], Marco Delsante[SUP] 10 [/SUP], Enrique Morales[SUP] 11 [/SUP], Eduardo Gutierrez[SUP] 11 [/SUP], Jose A Niño-Cruz[SUP] 12 [/SUP], Armando J Martinez-Rueda[SUP] 12 [/SUP], Giorgia Comai[SUP] 13 [/SUP], Claudia Bini[SUP] 13 [/SUP], Gaetano La Manna[SUP] 13 [/SUP], Maria F Slon[SUP] 14 [/SUP], Joaquin Manrique[SUP] 14 [/SUP], Alejandro Avello[SUP] 15 16 [/SUP], Raul Fernandez-Prado[SUP] 15 16 [/SUP], Alberto Ortiz[SUP] 15 16 [/SUP], Smaragdi Marinaki[SUP] 17 [/SUP], Carmen Rita Martin Varas[SUP] 18 [/SUP], Cristina Rabasco Ruiz[SUP] 19 [/SUP], Milagros Sierra-Carpio[SUP] 20 [/SUP], Rebeca García-Agudo[SUP] 21 [/SUP], Gema Fernández Juárez[SUP] 22 [/SUP], Alexander J Hamilton[SUP] 23 [/SUP], Annette Bruchfeld[SUP] 24 25 [/SUP], Constantina Chrysochou[SUP] 26 27 [/SUP], Lilian Howard[SUP] 1 [/SUP], Smeeta Sinha[SUP] 26 27 [/SUP], Tim Leach[SUP] 28 [/SUP], Irene Agraz Pamplona[SUP] 2 3 [/SUP], Umberto Maggiore[SUP] 10 [/SUP], Paolo Cravedi[SUP] 9 [/SUP]
Affiliations
Abstract
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-COVID-19 eGFR compared with controls (adjusted 6-month post-COVID-19 eGFR=0.41; 95% CI, 0.25 to 0.56; times pre-COVID-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.
Keywords: COVID-19; follow-up studies; glomerular and tubulointerstitial diseases; glomerular disease; kidney glomerulus; registries.
. 2021 Dec 3;3(2):293-306.
doi: 10.34067/KID.0006612021. eCollection 2022 Feb 24.
COVID-19 in Patients with Glomerular Disease: Follow-Up Results from the IRoc-GN International Registry
Meryl Waldman[SUP] 1 [/SUP], Maria Jose Soler[SUP] 2 3 [/SUP], Clara García-Carro[SUP] 2 3 [/SUP], Liz Lightstone[SUP] 4 5 [/SUP], Tabitha Turner-Stokes[SUP] 4 5 [/SUP], Megan Griffith[SUP] 5 [/SUP], Joan Torras[SUP] 6 [/SUP], Laura Martinez Valenzuela[SUP] 6 [/SUP], Oriol Bestard[SUP] 2 3 [/SUP], Colin Geddes[SUP] 7 [/SUP], Oliver Flossmann[SUP] 8 [/SUP], Kelly L Budge[SUP] 9 [/SUP], Chiara Cantarelli[SUP] 10 [/SUP], Enrico Fiaccadori[SUP] 10 [/SUP], Marco Delsante[SUP] 10 [/SUP], Enrique Morales[SUP] 11 [/SUP], Eduardo Gutierrez[SUP] 11 [/SUP], Jose A Niño-Cruz[SUP] 12 [/SUP], Armando J Martinez-Rueda[SUP] 12 [/SUP], Giorgia Comai[SUP] 13 [/SUP], Claudia Bini[SUP] 13 [/SUP], Gaetano La Manna[SUP] 13 [/SUP], Maria F Slon[SUP] 14 [/SUP], Joaquin Manrique[SUP] 14 [/SUP], Alejandro Avello[SUP] 15 16 [/SUP], Raul Fernandez-Prado[SUP] 15 16 [/SUP], Alberto Ortiz[SUP] 15 16 [/SUP], Smaragdi Marinaki[SUP] 17 [/SUP], Carmen Rita Martin Varas[SUP] 18 [/SUP], Cristina Rabasco Ruiz[SUP] 19 [/SUP], Milagros Sierra-Carpio[SUP] 20 [/SUP], Rebeca García-Agudo[SUP] 21 [/SUP], Gema Fernández Juárez[SUP] 22 [/SUP], Alexander J Hamilton[SUP] 23 [/SUP], Annette Bruchfeld[SUP] 24 25 [/SUP], Constantina Chrysochou[SUP] 26 27 [/SUP], Lilian Howard[SUP] 1 [/SUP], Smeeta Sinha[SUP] 26 27 [/SUP], Tim Leach[SUP] 28 [/SUP], Irene Agraz Pamplona[SUP] 2 3 [/SUP], Umberto Maggiore[SUP] 10 [/SUP], Paolo Cravedi[SUP] 9 [/SUP]
Affiliations
- PMID: 35373130
- PMCID: PMC8967646
- DOI: 10.34067/KID.0006612021
Abstract
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-COVID-19 eGFR compared with controls (adjusted 6-month post-COVID-19 eGFR=0.41; 95% CI, 0.25 to 0.56; times pre-COVID-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.
Keywords: COVID-19; follow-up studies; glomerular and tubulointerstitial diseases; glomerular disease; kidney glomerulus; registries.