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Long-term renal outcomes of patients with COVID-19: a meta-analysis of observational studies

Yuhui Zhang1,2,3,4, Youlu Zhao1,2,3,4, Jinwei Wang1,2,3,4

  • 1Renal Division, Peking University First Hospital, Beijing, China.

Journal of Nephrology
|October 3, 2023
PubMed

Insights

Long-term kidney damage is a concern for many coronavirus disease 2019 (COVID-19) survivors. A significant percentage of patients with COVID-19-associated acute kidney injury experience non-recovery, while others show decreased kidney function post-infection.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Public Health

Background:

  • Kidney damage is frequent in hospitalized coronavirus disease 2019 (COVID-19) patients.
  • Long-term renal outcomes following COVID-19 infection remain poorly understood.

Approach:

  • A systematic review and meta-analysis was conducted on long-term renal outcomes in COVID-19 patients.
  • Data from 12 moderate to high-quality cohort studies, including 6976 patients with COVID-19-associated acute kidney injury (AKI) and 5223 without AKI, were analyzed.
  • A random-effects meta-analysis of rates was performed, with the last search update on November 23, 2022.

Key Points:

  • Among COVID-19 patients with AKI, the long-term non-recovery rate was 22%, dialysis-dependent rate was 6%, and complete recovery rate was 63% over 90-326.5 days.
  • Higher comorbidity rates and renal replacement therapy rates correlated with increased non-recovery.
  • COVID-19 patients without AKI showed a 22% rate of long-term kidney function decrease within 90-199 days, influenced by infection severity.

Conclusions:

  • Patients with more comorbidities face higher renal non-recovery rates after COVID-19-associated AKI.
  • Kidney function decline can occur long-term even in COVID-19 patients without initial AKI.
  • Regular kidney function monitoring is recommended for high-risk patients during post-COVID-19 follow-up.
Abstract

Keywords:
Acute kidney injuryCOVID-19Long-term renal outcomeMeta-analysisSystematic review

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