Cornelissen Merel E B, Bloemsma Lizan D, Baalbaki Nadia, Twisk Jos W R, Downward George S, Maitland-van der Zee Anke-Hilse
Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Amsterdam Institute for Infection and Immunity, Amsterdam, The Netherlands.
Ren Fail. 2025 Dec;47(1):2551737. doi: 10.1080/0886022X.2025.2551737. Epub 2025 Sep 2.
Some degree of renal impairment is common during acute COVID-19 infection. However, it remains unclear whether this impairment is temporary or persists long term. In this study we compare kidney function ( estimated glomerular filtration rate [eGFR]) during infection, 3-6 months and 12-18 months after infection; the relationship between patient characteristics and eGFR in post COVID-19 patients; and the difference in eGFR between post COVID-19 patients and controls.
In total, 95 post COVID-19 patients and 94 controls were included. Post COVID-19 patients were seen 3-6 months and 12-18 months after infection for biological sample collection and questionnaire administration, with results for biological samples during acute infection sourced from medical records. Mixed model analyses were performed to study the associations between patient characteristics and eGFR and linear regression analyses to study the difference between post COVID-19 patients and controls.
Under a complete case analysis among post COVID-19 patients (where results available at the acute phase and both follow-up points, = 61), the eGFR was <90 mL/min/1.73 m in 50.8% during infection, in 68.9% at visit 1 and in 75.4% at visit 2, compared with 40.4% in the control group. The eGFR was lower among patients with a higher age, those who had been hospitalized, and those with CVD/hypertension. After adjusting for confounders, the eGFR at the 12-18 month time point was significantly lower in post COVID-19 patients than controls.
Previous COVID-19 infection was associated with a reduced eGFR up to 18 months after infection with higher age and CVD/hypertension increasing this likelihood.
在急性新型冠状病毒肺炎（COVID-19）感染期间，一定程度的肾功能损害较为常见。然而，这种损害是暂时的还是长期持续尚不清楚。在本研究中，我们比较了感染期间、感染后3 - 6个月和12 - 18个月的肾功能（估算肾小球滤过率[eGFR]）；COVID-19后患者的特征与eGFR之间的关系；以及COVID-19后患者与对照组之间eGFR的差异。
总共纳入了95例COVID-19后患者和94例对照。COVID-19后患者在感染后3 - 6个月和12 - 18个月接受生物样本采集和问卷调查，急性感染期间生物样本的结果来自病历。进行混合模型分析以研究患者特征与eGFR之间的关联，并进行线性回归分析以研究COVID-19后患者与对照组之间的差异。
在对COVID-19后患者进行的完整病例分析中（急性期以及两个随访点均有结果，n = 61），感染期间eGFR <90 mL/min/1.73 m²的患者比例为50.8%，随访1时为68.9%，随访2时为75.4%，而对照组为40.4%。年龄较大、曾住院以及患有心血管疾病/高血压的患者eGFR较低。在调整混杂因素后，COVID-19后患者在12 - 18个月时间点的eGFR显著低于对照组。
既往COVID-19感染与感染后长达18个月的eGFR降低有关，年龄较大以及患有心血管疾病/高血压会增加这种可能性。
