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Nephrol Dial Transplant ; 2023.
Article in English | PubMed | ID: covidwho-2189420


BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a remarkable kidney tropism. While kidney affection is common in severe coronavirus disease-2019 (COVID-19), data on non-severe courses is limited. Here we provide a multilevel analysis of kidney outcomes after non-severe COVID-19 to test for eventual kidney sequela. METHODS: This cross-sectional study investigates individuals after COVID-19 and matched controls recruited from the Hamburg City Health Study (HCHS) and its COVID-19 program. The HCHS is a prospective population-based cohort study within the city of Hamburg, Germany. During the COVID-19 pandemic the study additionally recruited subjects after PCR-confirmed SARS-CoV-2 infections. Matching was performed by age, sex, and education. Main outcomes were eGFR, albuminuria, Dickkopf3, hematuria, and pyuria. RESULTS: 443 subjects in median 9 months after non-severe COVID-19 were compared to 1328 non-COVID-19 subjects. Mean eGFR was mildly lower in post-COVID-19 than non-COVID-19 subjects, even after adjusting for known risk factors (beta -1.84, 95%-confidence interval (CI) -3.16 to -0.52). However, chronic kidney disease (OR 0.90, 95%-CI 0.48 to 1.66) or severely increased albuminuria (OR 0.76, 95%-CI 0.49 to 1.09) equally occurred in post-COVID-19 and non-COVID-19 subjects. Hematuria, pyuria, and proteinuria were also similar between the two cohorts suggesting no ongoing kidney injury after non-severe COVID-19. Further, Dickkopf3 was not increased in the post-COVID-19 cohort indicating no systematic risk for ongoing GFR decline (beta -72.19, 95%-CI -130.0 to -14.4). CONCLUSIONS: While mean eGFR was slightly lower in subjects after non-severe COVID-19, there was no evidence for an ongoing or progressive kidney sequela.

Journal of the American Society of Nephrology ; 33:308, 2022.
Article in English | EMBASE | ID: covidwho-2125909


Background: Diverse abnormal findings have been described after non-severe coronavirus disease 2019 (COVID-19) but kidney outcomes remain largely unknown. Here we analyze various kidney parameters after non-severe COVID-19 to test the hypothesis of a relevant kidney sequela. Method(s): This cross-sectional study investigates patients after non-severe COVID-19 and matched control subjects without prior COVID-19. Patients were recruited by the population-based Hamburg City Health Study (HCHS) as well as its associated COVID program. The HCHS is a prospective population-based cohort study on randomly selected residents of the city of Hamburg, Germany. During the COVID-19 pandemic the study also invited patients at least 4 months after a PCR proven severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection via newspaper announcements and an official COVID-19 test center. All patients had to be between 45 and 74 years of age. Matching was performed by age, sex, and education. Main outcomes were eGFR, albuminuria, Dickkopf3, hematuria, and pyuria. Descriptive analysis and mixed regression models were performed with adjustment for multiple testing by Bonferroni corrections. Result(s): The non-COVID cohort consisted of 1328 subjects, the post-COVID cohort of 443 patients in median 9 months after SARS-CoV-2 infection. Most patients had mild COVID-19. Only 31 patients were hospitalized with COVID-19 and no patient was treated on an intensive care unit. The risk for chronic kidney disease (CKD), defined by an eGFR < 60 ml/min/1.73m2, (OR 0.9, adjusted p=1.000) or severely increased albuminuria (OR 0.79, adj. p=0.893) was not increased in the post-COVID compared to the non-COVID cohort. This also applied for early CKD stages. However, mean eGFR was mildly lower in post-COVID subjects, even after adjusting for known risk factors (beta -1.84, adj. p=0.032). We found no elevation of hematuria, pyuria, and proteinuria for the post-COVID cohort suggesting no systematic ongoing kidney involvement. Urinary Dickkopf3 even tended to be lower in post-COVID patients indicating no risk for ongoing GFR decline in this cohort (beta -72.19, adj. p=0.072). Conclusion(s): While there is a subclinical eGFR drop after non-severe COVID-19, we found no evidence for a relevant kidney sequela nor ongoing renal involvement.

Clin Microbiol Infect ; 26(6): 729-734, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-17958


BACKGROUND: The 2019 novel coronavirus (SARS-CoV-2) is a new human coronavirus which is spreading with epidemic features in China and other Asian countries; cases have also been reported worldwide. This novel coronavirus disease (COVID-19) is associated with a respiratory illness that may lead to severe pneumonia and acute respiratory distress syndrome (ARDS). Although related to the severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS), COVID-19 shows some peculiar pathogenetic, epidemiological and clinical features which to date are not completely understood. AIMS: To provide a review of the differences in pathogenesis, epidemiology and clinical features of COVID-19, SARS and MERS. SOURCES: The most recent literature in the English language regarding COVID-19 has been reviewed, and extracted data have been compared with the current scientific evidence about SARS and MERS epidemics. CONTENT: COVID-19 seems not to be very different from SARS regarding its clinical features. However, it has a fatality rate of 2.3%, lower than that of SARS (9.5%) and much lower than that of MERS (34.4%). The possibility cannot be excluded that because of the less severe clinical picture of COVID-19 it can spread in the community more easily than MERS and SARS. The actual basic reproductive number (R0) of COVID-19 (2.0-2.5) is still controversial. It is probably slightly higher than the R0 of SARS (1.7-1.9) and higher than that of MERS (<1). A gastrointestinal route of transmission for SARS-CoV-2, which has been assumed for SARS-CoV and MERS-CoV, cannot be ruled out and needs further investigation. IMPLICATIONS: There is still much more to know about COVID-19, especially as concerns mortality and its capacity to spread on a pandemic level. Nonetheless, all of the lessons we learned in the past from the SARS and MERS epidemics are the best cultural weapons with which to face this new global threat.

Betacoronavirus/genetics , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Severe Acute Respiratory Syndrome/epidemiology , Basic Reproduction Number , COVID-19 , Coronavirus Infections/mortality , Coronavirus Infections/transmission , Humans , Pandemics , Phylogeny , Pneumonia, Viral/mortality , Pneumonia, Viral/transmission , SARS-CoV-2 , Severe Acute Respiratory Syndrome/complications , Severe Acute Respiratory Syndrome/mortality , Severe Acute Respiratory Syndrome/transmission , Virus Attachment