Kidney Week

Abstract: TH-PO1161

Long-Term Kidney Function of COVID-19 Survivors: A Prospective Cohort Study

Session Information

• COVID-19
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Ribeiro, Heitor S., Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Sao Paulo, Brazil

Heitor S. Ribeiro, PhD

• Frediani, Marcella Martins, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Sao Paulo, Brazil

Marcella Martins Frediani, MD

• Busatto, Geraldo F., Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Sao Paulo, Brazil

Geraldo F. Busatto, PhD

• Carvalho, Carlos Roberto Ribeiro, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Sao Paulo, Brazil

Carlos Roberto Ribeiro Carvalho, MD, MEd, PhD

• Marçal, Lia J., Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Sao Paulo, Brazil

Lia J. Marçal, PhD

• Santa Catharina, Guilherme P., Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Sao Paulo, Brazil

Guilherme P. Santa Catharina, MD

• Yu, Luis, Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Sao Paulo, Brazil

Luis Yu, MD, PhD

• Burdmann, Emmanuel A., Universidade de Sao Paulo Faculdade de Medicina, Sao Paulo, Sao Paulo, Brazil

Emmanuel A. Burdmann, MD, PhD

Group or Team Name

• HCFMUSP COVID-19 Study Group.

Background

Long COVID encompasses symptoms that persist >2 months. Its effects on kidney function remain poorly understood. We aimed to investigate the long-term kidney function of COVID-19 survivors.

Methods

A prospective cohort of moderate and severe COVID-19 surviving patients was analyzed. Eligible patients were contacted at 6–9 months after hospital discharge. Kidney function at hospital admission, discharge, and follow-up was assessed by estimated glomerular filtration rate (eGFR; CKD-EPI serum creatinine race-free equation). Urinary albumin was evaluated at follow-up. Major Adverse Kidney Events (MAKE) at follow-up was defined as eGFR <60 ml/min/1.73 m², eGFR decline ≥40% from discharge, or albuminuria (>30 mg/L). MAKE-associated factors were investigated by binary logistic regression.

Results

We assessed 655 patients (55±14 years, 45% ≥60 years, 46% female, 50% black). At hospital admission, eGFR was 82.2 ml/min/1.73 m² (IQR:49.3–103.5). During hospital stay (median 15 days), peak SCr was 1.52 (IQR:1.02–3.26), 67% were admitted to intensive care units, 46% required intubation, 79% had acute kidney injury (35% at admission; 43% during hospitalization), and 14% needed dialysis. At hospital discharge, eGFR was 92.3 (IQR:64.3–107.4). After 7.8±1.6 months of follow-up, 14% of the patients showed eGFR decline >40% (median -5.4%; IQR:-26.7 – 30.2), and 16% of the patients showed eGFR <60 ml/min/1.73 m². MAKE was found in 39% of the patients. The factors independently associated with MAKE were older age (odds ratio [OR]=1.54, 95%CI:1.11–2.14) and peak SCr (OR=1.20, 95%CI:1.10–1.32).

Conclusion

Long-term kidney dysfunction was found in a large proportion of COVID-19 survivors, suggesting that kidney long COVID might be a significant health problem. Older age and peak SCr during hospitalization were independent risk factors associated with MAKE.

Figure 1. eGFR overtime stratified by follow-up kidney function

Funding

• Government Support – Non-U.S.