Hiban Kayli, Mabila Sithembile L, Murray Jessica H, McQuistan Alexis A, Wells Natalie Y
Epidemiology and Analysis Branch, Armed Forces Health Surveillance Division, Defense Health Agency, U.S. Department of Defense, Silver Spring, MD.
MSMR. 2024 Dec 20;31(12):17-22.
Early evidence suggests that COVID-19 is linked to kidney-related events in older and hospitalized patients. This link has not, however, been explored among a younger, healthy population such as U.S. active component service members (ACSMs). This retrospective cohort study assessed the incidence of post-acute sequelae of SARS-CoV-2 (PASC) and kidney events between March 1, 2020 and September 30, 2022 in ACSMs with no prior history of kidney events. Among the study population (n=831,780), 1,975 (0.2%) kidney events were reported between 31 days and 6 months after COVID-19 test dates. The incidence rate of any kidney event was slightly higher among ACSMs who tested negative for COVID-19 (10.6 per 10,000 person-years) compared to ACSMs who tested positive (9.8 per 10,000 person-years). In adjusted models of incidence rate ratios (IRRs), older ACSMs evinced significantly higher rates of kidney events compared to younger ACSMs, and COVID-19 vaccination had a protective effect; this was true in both the COVID-19-positive and -negative groups, although the IRR magnitude was stronger in the COVID-19-positive group. PASC did not lead to an increased incidence of kidney events compared to the COVID-19-negative group among ACSMs, an overall young and healthy population. PASC-related kidney events were rare among a young, healthy population of ACSMs without prior history of kidney events. The incidence of kidney events among ACSMs was not higher in the COVID-positive group compared to the group that tested negative for COVID.
早期证据表明，新型冠状病毒肺炎（COVID-19）与老年和住院患者的肾脏相关事件有关。然而，在年轻、健康的人群中，如美国现役军人（ACSMs），尚未对这种联系进行研究。这项回顾性队列研究评估了2020年3月1日至2022年9月30日期间，无肾脏事件既往史的ACSMs中，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）急性后遗症（PASC）和肾脏事件的发生率。在研究人群（n = 831,780）中，在COVID-19检测日期后的31天至6个月内，报告了1,975例（0.2%）肾脏事件。与COVID-19检测呈阳性的ACSMs（每10,000人年9.8例）相比，COVID-19检测呈阴性的ACSMs中，任何肾脏事件的发生率略高（每10,000人年10.6例）。在发病率比（IRRs）的调整模型中，与年轻的ACSMs相比，年长的ACSMs肾脏事件发生率显著更高，且COVID-19疫苗接种具有保护作用；在COVID-19阳性和阴性组中均如此，尽管IRR幅度在COVID-19阳性组中更强。在总体年轻健康的ACSMs人群中，与COVID-19阴性组相比，PASC并未导致肾脏事件发生率增加。在无肾脏事件既往史的年轻健康ACSMs人群中，与PASC相关的肾脏事件很少见。与COVID检测呈阴性的组相比，COVID阳性组中ACSMs的肾脏事件发生率并不更高。
