Kidney Outcomes in Long COVID

作者：Benjamin Bowe, Yan Xie, Evan Xu, Ziyad Al-Aly · 发表于：Journal of the American Society of Nephrology · 年份：2021 · DOI：10.1681/asn.2021060734 · 被引用次数：352 · 研究领域：Long-Term Effects of COVID-19、COVID-19 Clinical Research Studies、Kawasaki Disease and Coronary Complications

Significance Statement Patients who survive coronavirus disease 2019 (COVID-19) are at higher risk of post-acute sequelae involving pulmonary and several extrapulmonary organ systems—generally referred to as long COVID. However, a detailed assessment of kidney outcomes in long COVID is not yet available. Here we show that, beyond the acute phase of illness, 30-day survivors of COVID-19 exhibited higher risks of AKI, eGFR decline, ESKD, major adverse kidney events (MAKE), and steeper longitudinal decline in eGFR. The risks of kidney outcomes increased according to the severity of the acute infection (categorized by care setting into non-hospitalized, hospitalized, and admitted to intensive care). The findings provide insight into the long-term consequences of COVID-19 on kidney outcomes and suggest that post-acute COVID-19 care should include attention to kidney function and disease. Background COVID-19 is associated with increased risk of post-acute sequelae involving pulmonary and extrapulmonary organ systems—referred to as long COVID. However, a detailed assessment of kidney outcomes in long COVID is not yet available. Methods We built a cohort of 1,726,683 US Veterans identified from March 1, 2020 to March 15, 2021, including 89,216 patients who were 30-day survivors of COVID-19 and 1,637,467 non-infected controls. We examined risks of AKI, eGFR decline, ESKD, and major adverse kidney events (MAKE). MAKE was defined as eGFR decline ≥50%, ESKD, or all-cause mortality. We us...