Boruga Madalina, Septimiu-Radu Susa, Nandarge Prashant Sunil, Elagez Ahmed, Doros Gabriela, Lazureanu Voichita Elena, Stoicescu Emil Robert, Tanase Elena, Iacob Roxana, Dumitrescu Andreea, Bota Adrian Vasile, Cotoraci Coralia, Bratu Melania Lavinia
Department of Toxicology, Drug Industry, Management and Legislation, Faculty of Pharmacology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Biomedicines. 2024 Apr 24;12(5):950. doi: 10.3390/biomedicines12050950.
The long-term sequelae of SARS-CoV-2 infection are still under research, since extensive studies showed plenty of systemic effects of the viral infection, extending even after the acute phase of the infection. This study evaluated kidney function tests six months after SARS-CoV-2 infection in patients clinically diagnosed with Post-COVID Syndrome, hypothesizing persistent renal dysfunction evidenced by altered kidney function tests compared to baseline levels. Continuous eGFR decrease <30 at six months post-infection was considered the main study outcome. Conducted at the "Victor Babes" Hospital, this retrospective observational study involved adults with laboratory-confirmed SARS-CoV-2 infection and clinically-diagnosed Post-COVID Syndrome, excluding those with prior chronic kidney disease or significant renal impairment. Kidney function tests, including serum creatinine, blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), alongside markers of kidney damage such as proteinuria and hematuria, were analyzed. Among 206 participants, significant differences were observed between the control ( = 114) and the Post-COVID group ( = 92). The Post-COVID group exhibited higher serum creatinine (109.7 μmol/L vs. 84.5 μmol/L, < 0.001), lower eGFR (65.3mL/min/1.73 m vs. 91.2 mL/min/1.73 m, < 0.001), and elevated BUN levels (23.7 mg/dL vs. 15.2 mg/dL, < 0.001) compared to the control group. Regression analysis highlighted significant predictors of continuous eGFR decrease <30 at six months post-infection. The development of acute kidney injury (AKI) during the initial COVID-19 illness emerged as a strong predictor of reduced eGFR (β = 3.47, < 0.001). Additional factors, including a creatinine increase (23 μmol/L above the normal range) and an elevated Albumin to Creatinine Ratio (ACR) (>11 mg/g above the normal range), were significantly associated with eGFR reduction. Patients with Post-COVID Syndrome demonstrate significant renal impairment six months post-SARS-CoV-2 infection. The study's findings stress the need for ongoing monitoring and intervention strategies for renal health in affected individuals, underscoring the persistent impact of COVID-19 on renal function.
由于大量研究表明新冠病毒感染存在诸多全身性影响,甚至在感染急性期过后仍持续存在,因此新冠病毒感染的长期后遗症仍在研究中。本研究评估了临床诊断为新冠后综合征的患者在感染新冠病毒六个月后的肾功能测试,假设与基线水平相比,肾功能测试结果改变可证明存在持续性肾功能障碍。感染后六个月时估算肾小球滤过率(eGFR)持续下降<30被视为主要研究结果。这项回顾性观察性研究在“维克托·巴比什”医院开展,纳入了实验室确诊感染新冠病毒且临床诊断为新冠后综合征的成年人,排除了既往有慢性肾病或严重肾功能损害的患者。分析了包括血清肌酐、血尿素氮(BUN)、估算肾小球滤过率(eGFR)在内的肾功能测试,以及蛋白尿和血尿等肾损伤标志物。在206名参与者中,对照组(n = 114)和新冠后组(n = 92)之间观察到显著差异。与对照组相比,新冠后组血清肌酐水平更高(109.7μmol/L对84.5μmol/L,P<0.001),eGFR更低(65.3mL/min/1.73m²对91.2mL/min/1.73m²,P<0.001),BUN水平升高(23.7mg/dL对15.2mg/dL,P<0.001)。回归分析突出了感染后六个月时eGFR持续下降<30的显著预测因素。新冠病毒疾病初期发生急性肾损伤(AKI)是eGFR降低的有力预测因素(β = 3.47,P<0.001)。其他因素,包括肌酐升高(高于正常范围23μmol/L)和白蛋白与肌酐比值(ACR)升高(高于正常范围>11mg/g),与eGFR降低显著相关。新冠后综合征患者在感染新冠病毒六个月后表现出显著的肾功能损害。该研究结果强调了对受影响个体的肾脏健康进行持续监测和干预策略的必要性,凸显了新冠病毒对肾功能的持续影响。