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Long-term kidney outcomes after COVID-19: a matched cohort study using the OpenSAFELY platform
Viyaasan Mahalingasivam1,2, Bang Zheng1, Kevin Wing3
1Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
The Lancet Regional Health. Europe
|September 15, 2025
Summary
COVID-19 hospitalization significantly increases long-term kidney failure risk, especially in Black individuals. Kidney function monitoring is crucial post-discharge for those hospitalized with COVID-19.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- COVID-19 is frequently linked to acute kidney injury in hospitalized patients.
- Long-term kidney outcomes in the general population after COVID-19 infection remain under-researched.
Purpose of the Study:
- To investigate the association between COVID-19 and long-term kidney outcomes.
- To assess risks stratified by hospitalization status and ethnicity.
Main Methods:
- Population-based, matched cohort study using UK electronic health records (OpenSAFELY-TPP).
- Comparison of individuals with and without COVID-19 using Cox models.
- Outcomes included kidney failure, 50% kidney function reduction, and death.
Main Results:
- COVID-19 was associated with increased kidney failure (HR 1.93).
- Hospitalization dramatically elevated kidney failure risk (HR 7.74), persisting beyond 180 days.
- No increased risk observed in non-hospitalized individuals (HR 0.85).
- Higher risk in Black ethnicity (HR 4.50) compared to White ethnicity (HR 1.82).
- Kidney failure risk remained high across COVID-19 waves for hospitalized patients.
Conclusions:
- Hospitalization with COVID-19 leads to increased long-term kidney outcomes.
- Significant ethnic disparities exist in kidney failure risk post-COVID-19.
- Proactive kidney function monitoring is recommended for discharged patients, with optimized prevention strategies for vulnerable groups.
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