COVID-19 Infection Is a Risk Factor for CKD and Glomerulonephritis

ABSTRACT

Background: The ongoing COVID19 pandemic continues to challenge healthcare systems. While COVID19 disease is associated with Acute Kidney Injury and collapsing glomerulonephritis, little is known about the potential kidney manifestations of PASC (Post-Acute Sequelae of COVID19). In this study we used TrinetX, a large health research network that aggregates data from multiple centers in the United States to analyze the effects of COVID19 on chronic kidney disease (CKD) manifestations of PASC. Method(s) We searched TrinetX for patients > 18 years old with a documented SARSCOV-2 PCR test and classified them into 2 cohorts C19+ve (with a [+] molecular test for SARS-COV-2 or a clinical diagnosis of COVID19 disease) and C19-ve (absence of such findings). We excluded patients who had received any COVID19 vaccine. We collected demographics, comorbidities, diagnoses for up to two years after any COVID19 PCR test (index event). A 11 propensity score matching (PSM) using the nearest neighbor method was used to balance the 2 cohorts on age, gender, Hispanic ethnicity, black race, hypertension, diabetes, heart failure and atherosclerosis. Patients with a kidney specific diagnosis prior to their COVID19 PCR test were excluded. Result(s) We identified 2,780,780 C19+ve and 6,757,849 C19-ve patients. After PSM each group contained 2,775,418 subjects. Mean age was 40.2+/-23.1, females were 54.7%, blacks were 15.8% & 12.3% were Hispanic or Latinos. COVID19 diagnosis was a strong risk factor for CKD (Relative Risk, RR 2.474, p<0.001), nephritic, nephrotic syndrome and glomerular disorders. Conclusion(s) COVID19 disease is a major risk factor for incident CKD, nephrotic and nephritic syndrome. These findings should be confirmed in prospective studies. Whether these sequalae represent persistence of the kidney tropic SARS-COV-2 virus, vascular damage from the acute infection or a manifestation of autoimmunity can only be established through targeted mechanistic studies.