Kidney Damage in Patients With Long Covid: Cross-sectional Clinical Study
Year: 2024
Type: conference-abstract
Abstract: Introduction: After mild and severe COVID-19 clinical manifestation, some patients may evolve to multiple organ dysfunction syndrome (MODS), including kidney injury which may the risk of death. Even patients who do not present changes in glomerular filtration, according to KDIGO criteria, may show changes in proximal tubule protein reabsorption, so-called subclinical Acute Kidney Injury (subAKI). However, the clinical presentation of SARS-CoV-2 infection (Long COVID) in kidney function is poorly understood. Objective: To evaluate the prevalence of kidney injury and the glomerular and tubular involvements in Long COVID patients. Method: This is a cross-sectional clinical study in patients diagnosed with COVID-19 between March 2020 and April 2022 (CAAE: 53517521.6.0000.5257). Patients with previous kidney disease were excluded. Participants (n=75) were divided into three groups: 6 (n=36), 12 (n=24) and 24 (n=15) months-post-COVID-19 (MPC). Clinical and laboratory data during hospitalization and after discharge through outpatient follow-up were evaluated. Estimated glomerular filtration rate (eGFR) was assessed using the CKD-EPI method and expressed as ml/min/1.73m². The tubular injury score was developed to measure the degree of tubular injury. Chi-square and Kruskal-Wallis tests with Bonferroni adjustments were used for statistical analyses. Results: The overall population was 59 years-old and 58.6% were women. Overall, 50.7% showed a reduction in eGFR, 34.6% of patients showed a mildly reduction (between 90-60 ml/min/1.73m²) while 16% showed marked reduction (< 60 ml/min/1.73m²). The prevalence of mildly eGFR reduction (between 90-60 ml/min/1.73m²) was higher in those patients with longer period after infection (6-MPC: 27.7%; 12-MPC: 37.5%; 24-MPC: 46.6%). For those patients with marked reduction eGFR (< 60 ml/min/1.73m²), the prevalence was not different among the groups (6-MPC: 16.7%; 12-MPC: 16.7%; 24-MPC: 13.3%). Overall, 50.6% of patients showed tubular injury measured by albuminuria, urinary excretion of β2-microglobulin and/or KIM-1. Conclusion: The present study showed that glomerular injury is progressive and more prevalent over time while tubular injury, present in all groups, tends to be reversed over time. These data suggest a decoupling between glomerular and tubular injuries in Long COVID patients.
Authors: Caio Vettorazzi Barboza Menário¹, Rodrigo Pacheco da Silva de Aguiar¹, Gabriela da Silva Nascimento¹, Nina Rocha Godinho dos Reis Visconti², Luana de Souza Andrade², Fernanda Carvalho de Queiroz Mello², José Roberto Lapa e Silva², Nazareth de Novaes Rocha³, Camila Marinelli Martins⁴, Fernanda Ferreira Cruz¹, Ana Acácia de Sá Pinheiro¹, Pedro Leme Silva¹, Patricia Rieken Macêdo Rocco¹, Celso Caruso-Neves¹
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4415776739