Teng Lanbo, Song Xinyuan, Zhang Miaomiao, Han Yingying, Chang Ge, Chang Wenxiu, Shen Zhongyang
Department of Nephrology, Tianjin First Center Hospital, Nankai University, Tianjin, China.
National Health Commission (NHC) Key Laboratory for Critical Care Medicine, Tianjin First Center Hospital, Tianjin, China.
J Med Virol. 2023 Feb;95(2):e28477. doi: 10.1002/jmv.28477.
To analyze the dynamic changes of renal function longitudinally and investigate the cytokine profiles at 6 months in patients with Omicron COVID-19. Forty-seven patients with a proven diagnosis of Omicron COVID-19 from January to February 2022 attended a 6-month follow-up after discharge at Tianjin First Central Hospital. The demographic parameters, clinical features, and laboratory indexes were collected during hospitalization and 6 months after discharge. The serum cytokine levels at 6 months were also assessed. Patients were grouped according to with or without kidney involvement at admission. The levels of serum creatinine and estimated glomerular filtration rate (eGFR) were all normal both in the hospital and at follow-up. Whereas, compared with renal function in the hospital, serum creatinine levels at 6 months increased remarkably; meanwhile, eGFR decreased significantly in all patients. The serum levels of interleukin (IL)-2, IL-4, IL-5, IL-6, IL-10, and TNF-α and IFN-γ significantly decreased and TGF-β remarkably increased in the kidney involvement group. The serum levels of IL-2 and IL-5 were positively correlated with age; contrarily, TGF-β showed a negative correlation with aging. The younger was an independent risk factor of the higher TGF-β levels. Omicron patients showed a decline in renal function at follow-up, reflecting the trend of CKD. Serum cytokine profiles were characterized with the majority of cytokines decreased and TGF-β increased in the kidney involvement group; the latter may be used as a sign of CKD. The tendency of CKD is one of the manifestations of long COVID and deserves attention.
纵向分析新型冠状病毒 Omicron 感染患者肾功能的动态变化，并研究其6个月时的细胞因子谱。2022年1月至2月确诊为新型冠状病毒 Omicron 感染的47例患者在天津市第一中心医院出院后进行了6个月的随访。收集住院期间和出院后6个月的人口统计学参数、临床特征和实验室指标。还评估了6个月时的血清细胞因子水平。根据入院时是否有肾脏受累将患者分组。住院期间和随访时血清肌酐水平和估算肾小球滤过率（eGFR）均正常。然而，与住院时的肾功能相比，6个月时血清肌酐水平显著升高；同时，所有患者的eGFR均显著下降。肾脏受累组血清白细胞介素（IL）-2、IL-4、IL-5、IL-6、IL-10、肿瘤坏死因子-α（TNF-α）和干扰素-γ（IFN-γ）水平显著降低，转化生长因子-β（TGF-β）显著升高。IL-2和IL-5的血清水平与年龄呈正相关；相反，TGF-β与衰老呈负相关。年龄较小是TGF-β水平较高的独立危险因素。新型冠状病毒 Omicron 感染患者随访时肾功能下降，反映了慢性肾脏病（CKD）的趋势。肾脏受累组血清细胞因子谱的特征是大多数细胞因子降低而TGF-β升高；后者可能作为CKD的一个标志。CKD的趋势是新冠后遗症的表现之一，值得关注。
