The Time-Varying Impact of COVID-19 on the Acute Kidney Disorders: A Historical Matched Cohort Study and Mendelian Randomization Analysis

Overview

Journal Health Data Sci

Specialty Medical Informatics

Date 2024 Jul 16

PMID 39011273

Authors

Chunyang Li

Chao Zhang

Jie Chen

Yilong Chen

Zhiye Ying

Yao Hu

Huan Song

Ping Fu

Xiaoxi Zeng

Affiliations

Soon will be listed here.

Abstract

This study aimed to explore the time-varying impact of COVID-19 on acute kidney disorders, including acute kidney injury and other acute kidney diseases. From the UK Biobank, 10,121 participants with COVID-19 were matched with up to 3 historically unexposed controls by age, sex, Townsend deprivation index, and the status of hospitalization or receiving critical care. We investigated the association between COVID-19 and incidence of acute kidney disorders, within the first 4 weeks after infection, using conditional and time-varying Cox proportional hazard regression. In addition, one-sample Mendelian randomization, utilizing the polygenic risk score for COVID-19 as an instrumental variable, was conducted to explore the potential causality of the association. In the matched cohort study, we observed a significant association between COVID-19 and acute kidney disorders predominantly within the first 3 weeks. The impact of COVID-19 was time dependent, peaking in the second week (hazard ratio, 12.77; 95% confidence interval, 5.93 to 27.70) and decreasing by the fourth week (hazard ratio, 2.28; 95% confidence interval, 0.75 to 6.93). In subgroup analyses, only moderate to severe COVID-19 cases were associated with acute worsening of renal function in a time-dependent pattern. One-sample Mendelian randomization analyses further showed that COVID-19 might exert a "short-term" causal effect on the risk of acute kidney disorders, primarily confined to the first week after infection. The risk of acute kidney disorders following COVID-19 demonstrates a time-varying pattern. Hazard effects were observed only in patients with moderate or severe but not mild COVID-19.

Citing Articles

Detrimental Effects of Anti-Nucleocapsid Antibodies in SARS-CoV-2 Infection, Reinfection, and the Post-Acute Sequelae of COVID-19.

Nakayama E, Shioda T Pathogens. 2025; 13(12.

PMID: 39770368 PMC: 11728538. DOI: 10.3390/pathogens13121109.

References

Adiyeke E, Ren Y, Guan Z, Ruppert M, Rashidi P, Bihorac A . Clinical courses of acute kidney injury in hospitalized patients: a multistate analysis. Sci Rep. 2023; 13(1):17781. PMC: 10584933. DOI: 10.1038/s41598-023-45006-5. View

Li C, Chen Y, Chen Y, Ying Z, Hu Y, Kuang Y . The Causal Association of Irritable Bowel Syndrome with Multiple Disease Outcomes: A Phenome-Wide Mendelian Randomization Study. J Clin Med. 2023; 12(3). PMC: 9918111. DOI: 10.3390/jcm12031106. View

Gudivada K, Narayan S, Narasimha A, Krishna B, Muralidhara K . Evaluation of Predictors, Kinetics of Renal Recovery and Outcomes of COVID-19 Patients with Acute Kidney Injury Admitted to Intensive Care Unit: An Observational Study. Indian J Crit Care Med. 2023; 26(12):1293-1299. PMC: 9886020. DOI: 10.5005/jp-journals-10071-24372. View

Hou C, Hu Y, Yang H, Chen W, Zeng Y, Ying Z . COVID-19 and risk of subsequent life-threatening secondary infections: a matched cohort study in UK Biobank. BMC Med. 2021; 19(1):301. PMC: 8592806. DOI: 10.1186/s12916-021-02177-0. View

Chen K, Lei Y, He Y, Xiao F, Yu Y, Lai X . Clinical outcomes of hospitalized COVID-19 patients with renal injury: a multi-hospital observational study from Wuhan. Sci Rep. 2021; 11(1):15205. PMC: 8313555. DOI: 10.1038/s41598-021-94570-1. View

Lu J, Boparai M, Shi C, Henninger E, Rangareddy M, Veeraraghavan S . Long-term outcomes of COVID-19 survivors with hospital AKI: association with time to recovery from AKI. Nephrol Dial Transplant. 2023; 38(10):2160-2169. DOI: 10.1093/ndt/gfad020. View

Yaqub S, Hamid A, Saeed M, Awan S, Farooque A, Tareen H . Clinical Characteristics and Outcomes of Acute Kidney Injury in Hospitalized Patients with Coronavirus Disease 2019: Experience at a Major Tertiary Care Center in Pakistan. Saudi J Kidney Dis Transpl. 2023; 33(6):784-794. DOI: 10.4103/1319-2442.390258. View

Kalish H, Klumpp-Thomas C, Hunsberger S, Baus H, Fay M, Siripong N . Undiagnosed SARS-CoV-2 seropositivity during the first 6 months of the COVID-19 pandemic in the United States. Sci Transl Med. 2021; 13(601). PMC: 8432952. DOI: 10.1126/scitranslmed.abh3826. View

. The COVID-19 Host Genetics Initiative, a global initiative to elucidate the role of host genetic factors in susceptibility and severity of the SARS-CoV-2 virus pandemic. Eur J Hum Genet. 2020; 28(6):715-718. PMC: 7220587. DOI: 10.1038/s41431-020-0636-6. View

10.

Yoo Y, Wilkins K, Alakwaa F, Liu F, Torre-Healy L, Krichevsky S . Geographic and Temporal Trends in COVID-Associated Acute Kidney Injury in the National COVID Cohort Collaborative. Clin J Am Soc Nephrol. 2023; 18(8):1006-1018. PMC: 10564368. DOI: 10.2215/CJN.0000000000000192. View

11.

Sathiavageesan S, Sundaram V, Sundaram N, Shanmugam V, Selvaraj J, Vivek N . Fulminant onset COVID-19: predictors and outcome. Postgrad Med J. 2023; 98(1164):742-749. DOI: 10.1136/postgradmedj-2022-141724. View

12.

Na K, Kim H, Ham Y, Choi D, Lee K, Moon J . Acute Kidney Injury and Kidney Damage in COVID-19 Patients. J Korean Med Sci. 2020; 35(28):e257. PMC: 7371456. DOI: 10.3346/jkms.2020.35.e257. View

13.

Kondratiuk A, Pillay T, Kon O, Lalvani A . A conceptual framework to accelerate the clinical impact of evolving research into long COVID. Lancet Infect Dis. 2021; 21(6):756-757. PMC: 8062085. DOI: 10.1016/S1473-3099(21)00136-5. View

14.

Papalia G, Barbuto S, Campus A, Vischini G . Double glomerulopathies or two-faced janus? A challenging case in the COVID-19 era. J Nephrol. 2022; 36(1):225-228. PMC: 9169020. DOI: 10.1007/s40620-022-01351-8. View

15.

Austin P . Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples. Stat Med. 2009; 28(25):3083-107. PMC: 3472075. DOI: 10.1002/sim.3697. View

16.

Bruchfeld A . The COVID-19 pandemic: consequences for nephrology. Nat Rev Nephrol. 2020; 17(2):81-82. PMC: 7703720. DOI: 10.1038/s41581-020-00381-4. View

17.

Mohr N, Harland K, Krishnadasan A, Ten Eyck P, Mower W, Willey J . Diagnosed and Undiagnosed COVID-19 in US Emergency Department Health Care Personnel: A Cross-sectional Analysis. Ann Emerg Med. 2021; 78(1):27-34. PMC: 7746085. DOI: 10.1016/j.annemergmed.2020.12.007. View

18.

Carriazo S, Mas-Fontao S, Seghers C, Cano J, Goma E, Avello A . Increased 1-year mortality in haemodialysis patients with COVID-19: a prospective, observational study. Clin Kidney J. 2022; 15(3):432-441. PMC: 8755355. DOI: 10.1093/ckj/sfab248. View

19.

Wan E, Mathur S, Zhang R, Yan V, Lai F, Chui C . Association of COVID-19 with short- and long-term risk of cardiovascular disease and mortality: a prospective cohort in UK Biobank. Cardiovasc Res. 2023; 119(8):1718-1727. DOI: 10.1093/cvr/cvac195. View

20.

Radovic S, Meng W, Chen L, Paniz Mondolfi A, Bryce C, Grimes Z . SARS-CoV-2 infection of kidney tissues from severe COVID-19 patients. J Med Virol. 2023; 95(2):e28566. PMC: 10388714. DOI: 10.1002/jmv.28566. View