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COVID-19 in Patients with Glomerular Disease: Follow-Up Results from the IRoc-GN International Registry

Meryl Waldman1, Maria Jose Soler2,3, Clara García-Carro2,3

  • 1Kidney Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.

Kidney360
|April 4, 2022
PubMed

Insights

COVID-19 infection did not increase mortality or acute kidney injury (AKI) in glomerulonephritis (GN) patients. However, GN patients face higher risks of impaired kidney function recovery after COVID-19-associated AKI.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on individuals with glomerulonephritis (GN) remains incompletely understood.
  • The International Registry of COVID-19 infection in GN was established to investigate these effects.

Purpose of the Study:

  • To evaluate the acute and long-term effects of COVID-19 on patients with GN.
  • To compare outcomes between GN patients and non-GN controls following SARS-CoV-2 infection.

Main Methods:

  • Serial data on kidney-related and unrelated outcomes were collected from 125 GN patients and 83 non-GN controls with COVID-19.
  • Follow-up duration was a median of 6.4 months post-diagnosis.
  • Logistic regression and linear mixed models were used for outcome and eGFR analyses, adjusted for confounders.

Main Results:

  • No significant differences in mortality or acute kidney injury (AKI) were observed between GN patients and controls after adjusting for pre-COVID-19 eGFR and other factors.
  • Pre-COVID-19 eGFR was the primary predictor of AKI (aOR per 1 SD decrease = 3.04, P<0.001).
  • GN patients with COVID-19-associated AKI showed significantly lower eGFR recovery at 6 months compared to controls (aOR=0.41). Factors like shorter GN duration, higher proteinuria, and specific diagnoses (FSGS, MCD) were linked to poorer eGFR recovery.

Conclusions:

  • Baseline eGFR is the key risk factor for AKI in COVID-19, irrespective of GN diagnosis.
  • Glomerulonephritis patients exhibit a heightened risk of impaired eGFR recovery post-COVID-19-associated AKI.
  • Close monitoring of GN patients, particularly those with high proteinuria or diagnoses of FSGS/MCD, is crucial during and after acute COVID-19 illness.
Abstract

Keywords:
COVID-19follow-up studiesglomerular and tubulointerstitial diseasesglomerular diseasekidney glomerulusregistries

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