COVID-19 outcomes in patients with a history of immune-mediated glomerular diseases

oleh: Philipp Gauckler, Jana S. Kesenheimer, Duvuru Geetha, Balazs Odler, Balazs Odler, Kathrin Eller, Timothee Laboux, Timothee Laboux, Federico Alberici, Mattia Zappa, Natasha Chebotareva, Sergey Moiseev, Marco Bonilla, Kenar D. Jhaveri, Julie Oniszczuk, Vincent Audard, Denise Costa, Denise Costa, Gianna Mastroianni-Kirsztajn, Annette Bruchfeld, Annette Bruchfeld, Masahiro Muto, Martin Windpessl, Gert Mayer, Andreas Kronbichler, Andreas Kronbichler

Format: Article
Diterbitkan: Frontiers Media S.A. 2023-09-01

Deskripsi

IntroductionPatients with immune-mediated glomerular diseases are considered at high risk for severe COVID-19 outcomes. However, conclusive evidence for this patient population is scarce.MethodsWe created a global registry and retrospectively collected clinical data of patients with COVID-19 and a previously diagnosed immune-mediated glomerular disease to characterize specific risk factors for severe COVID-19 outcomes.ResultsFifty-nine patients with a history of immune-mediated glomerular diseases were diagnosed with COVID-19 between 01.03.2020 and 31.08.2021. Over a mean follow-up period of 24.79 ± 18.89 days, ten patients (16.9%) developed acute kidney injury. Overall, 44.1% of patients were managed in an outpatient setting and therefore considered as having “non-severe” COVID-19, while 55.9% of patients had severe COVID-19 requiring hospitalization including worse outcomes. Comparing both groups, patients with severe COVID-19 were significantly older (53.55 ± 17.91 versus 39.77 ± 14.95 years, p = .003), had lower serum albumin levels at presentation (3.00 ± 0.80 g/dL versus 3.99 ± 0.68 g/dL, p = .016) and had a higher risk of developing acute kidney injury (27% versus 4%, p = .018). Male sex (p <.001) and ongoing intake of corticosteroids at presentation (p = .047) were also significantly associated with severe COVID-19 outcomes, while the overall use of ongoing immunosuppressive agents and glomerular disease remission status showed no significant association with the severity of COVID-19 (p = .430 and p = .326, respectively).ConclusionOlder age, male sex, ongoing intake of corticosteroids and lower serum albumin levels at presentation were identified as risk factors for severe COVID-19 outcomes in patients with a history of various immune-mediated glomerular diseases.