Risk for rapid kidney decline greater with COVID-19 vs. pneumonia
Key takeaways:
- Both infections were associated with an annual eGFR decline, but the drop was larger with COVID-19.
- Mean annual eGFR decline after COVID-19 infection was 3.4%.
Adults with COVID-19 may be at higher risk for rapid kidney decline after hospitalization compared with other respiratory infections, such as pneumonia, data show.
“While histopathological series have raised the possibility of irreversible damage, epidemiological inquiry into long-term outcomes has been limited,” Viyaasan Mahalingasivam, MPhil, of the London School of Hygiene and Tropical Medicine in the department of non-communicable disease epidemiology, and colleagues wrote. Studies show “increased adverse kidney outcomes after COVID-19 compared with individuals without the infection, with conflicting findings among individuals with influenza. Besides the differences in settings, definitions and duration of follow-up, a common limitation of prior studies has been the lack of consideration of preexisting kidney function trajectory, which may explain both postinfection decline and the need for function monitoring.”
Researchers analyzed data from the Stockholm Creatinine Measurements Project collected from 2018 to 2022 on 134,565 adults in a COVID-19 cohort and 35,987 individuals in a pneumonia cohort. The researchers investigated whether kidney function decline ramped up after COVID-19 vs. after other respiratory tract infections.
Of the COVID-19 cohort, 55.6% were women and the median age was 51 years. In the pneumonia group, 53.8% women and the median age was 71 years.
All participants had at least one eGFR recorded in the 2 years before testing positive for COVID-19 or pneumonia. Researchers assessed eGFR changes following either infection.
Median eGFR at baseline was 94 mL/min/1.73 m2 in the COVID-19 cohort and 79 mL/min/1.73 m2 in the pneumonia group, according to the researchers. Mahalingasivam and colleagues noted that both infections were associated with an annual eGFR decline; however, the drop was greater in adults with COVID-19. Mean annual eGFR decline after COVID-19 infection was 3.4% (95%; CI, 3.2%-3.5%) and was 2.3% (95% CI, 2.1%-2.5%) for pneumonia.
Further, adults with COVID-19 had a more severe decline of 5.4% (95%; CI, 5.2%-5.6%), while decline in hospitalized patients with pneumonia remained stable, the researchers found.
“We therefore propose people who were hospitalized for COVID-19 receive closer monitoring of kidney function to ensure prompt diagnosis and optimized management of chronic kidney disease to prevent complications and further decline,” they wrote.
Collapse