Kidney outcome after mild to moderate COVID-19

• Published in: Nephrology, dialysis, transplantation Vol. 38; no. 9; pp. 2031 - 2040
• Main Authors: Schmidt-Lauber, Christian, Hänzelmann, Sonja, Schunk, Stefan, Petersen, Elina L, Alabdo, Ammar, Lindenmeyer, Maja, Hausmann, Fabian, Kuta, Piotr, Renné, Thomas, Twerenbold, Raphael, Zeller, Tanja, Blankenberg, Stefan, Fliser, Danilo, Huber, Tobias B
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 31.08.2023
• Subjects: Original; COVID-19; kidney; sequela; SARS-CoV-2; CKD; albuminuria; chronic kidney disease
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfad008

ABSTRACT Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a remarkable kidney tropism. While kidney effects are common in severe coronavirus disease 2019 (COVID-19), data on non-severe courses are limited. Here we provide a multilevel analysis of kidney outcomes after non-severe COVID-19 to test for eventual kidney sequela. Methods This cross-sectional study investigates individuals after COVID-19 and matched controls recruited from the Hamburg City Health Study (HCHS) and its COVID-19 program. The HCHS is a prospective population-based cohort study within the city of Hamburg, Germany. During the COVID-19 pandemic the study additionally recruited subjects after polymerase chain reaction–confirmed SARS-CoV-2 infections. Matching was performed by age, sex and education. Main outcomes were estimated glomerular filtration rate (eGFR), albuminuria, Dickkopf3, haematuria and pyuria. Results A total of 443 subjects in a median of 9 months after non-severe COVID-19 were compared with 1328 non-COVID-19 subjects. The mean eGFR was mildly lower in post-COVID-19 than non-COVID-19 subjects, even after adjusting for known risk factors {β = −1.84 [95% confidence interval (CI) −3.16 to −0.52]}. However, chronic kidney disease [odds ratio (OR) 0.90 (95% CI 0.48–1.66)] or severely increased albuminuria [OR 0.76 (95% CI 0.49–1.09)] equally occurred in post-COVID-19 and non-COVID-19 subjects. Haematuria, pyuria and proteinuria were also similar between the two cohorts, suggesting no ongoing kidney injury after non-severe COVID-19. Further, Dickkopf3 was not increased in the post-COVID-19 cohort, indicating no systematic risk for ongoing GFR decline [β = −72.19 (95% CI −130.0 to −14.4)]. Conclusion While mean eGFR was slightly lower in subjects after non-severe COVID-19, there was no evidence for ongoing or progressive kidney sequela. Graphical Abstract Graphical Abstract