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Kidney Week

Abstract: PO0046

Kidney Outcomes in Long COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Bowe, Benjamin Charles, Veterans Health Administration, St. Louis, Missouri, United States
  • Xie, Yan, Veterans Health Administration, St. Louis, Missouri, United States
  • Xu, Evan, Veterans Health Administration, St. Louis, Missouri, United States
  • Gibson, Andrew K., Veterans Health Administration, St. Louis, Missouri, United States
  • Al-Aly, Ziyad, Veterans Health Administration, St. Louis, Missouri, United States
Background

Early epidemiologic evidence has suggested that the coronavirus disease 2019 (COVID-19) increases the risk for subsequent disease even after its acute phase. We aimed to describe post-acute kidney disease sequalae of COVID-19.

Methods

In a cohort of 1726683 US Veterans identified from March 01, 2020 to March 15, 2021, we examined the risk of AKI, progression of kidney disease, ESKD, and MAKE following the acute phase of the infection (30 days) in those with COVID-19 (89216) compared to those without (1637467), using weighted survival regressions. Linear mixed models characterized intra-individual eGFR trajectory.

Results

In a cohort of US Veterans with a median follow up of 172 days (IQR: 133-281), those with COVID-19 were at a higher risk of AKI (aHR=1.94 (95%CI: 1.86-2.04)), eGFR decline ≥30% (1.29 (1.25-1.34)), eGFR decline ≥40% (1.44 (1.37-1.51)), eGFR decline ≥50% (1.62 (1.51-1.74)), ESKD (2.96 (2.49-3.51)), and MAKE (1.66 (1.58-1.74)). Compared to non-hospitalized Veterans without COVID-19, excess burden 6 months after infection was higher by severity of COVID-19 infection, including AKI (3.17, 45.21, and 74.19 per 1000 persons in those non-hospitalized, hospitalized, and admitted to ICU, respectively), eGFR decline ≥ 30% (3.01, 44.71, 72.23), and MAKE (2.01, 31.92, 79.13). COVID-19 was associated with an excess rate of decline in eGFR following the acute phase of the infection (-2.30, -7.68, -9.70 mL/min/1.73m2/year in those non-hospitalized, hospitalized, and admitted to ICU).

Conclusion

COVID-19 is associated with increased risk of adverse kidney outcomes after the first 30 days of the infection; excess burden was higher in those with a more severe infection.

Funding

  • Veterans Affairs Support