Accelerated kidney function decline seen with COVID-19 versus pneumonia

COVID-19 is associated with accelerated decline in kidney function, especially after hospitalization, according to a study published online Dec. 26 in JAMA Network Open.

Viyaasan Mahalingasivam, from the London School of Hygiene and Tropical Medicine, and colleagues examined whether kidney function decline accelerated after COVID-19 versus other respiratory infections in a cohort study using linked data from the Stockholm Creatinine Measurements Project between Feb. 1, 2018, and Jan. 1, 2022. Data were included for all hospitalized and nonhospitalized adults in the database with at least one estimated glomerular filtration rate (eGFR) measurement in the two years prior to a COVID-19 positive test result (134,565 individuals) or pneumonia diagnosis (35,987 individuals).

The median baseline eGFR was 94 and 79 mL/min/1.73 m² for the COVID-19 and pneumonia cohorts, respectively. The researchers found that both infections demonstrated accelerated annual eGFR decline after adjustment for covariates, with a greater magnitude of decline seen after COVID-19 than pneumonia (3.4 and 2.3 percent, respectively). Among individuals hospitalized for COVID-19, the decline was more severe (5.4 percent) but was similar among those hospitalized for pneumonia.

“We therefore propose that people who were hospitalized for COVID-19 receive closer monitoring of kidney function to ensure prompt diagnosis and optimized management of chronic kidney disease to effectively prevent complications and further decline,” the authors write.

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