Long-term kidney outcomes after COVID-19: a matched cohort study using the OpenSAFELY platform

IF 13 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Europe Pub Date : 2025-08-01 DOI:10.1016/j.lanepe.2025.101338

Viyaasan Mahalingasivam , Bang Zheng , Kevin Wing , Edward P.K. Parker , Krishnan Bhaskaran , Juan Jesús Carrero , Sandra Jayacodi , Edith Jumbo , Tamanna Miah , Brian Gracey , John Tazare , Shalini Santhakumaran , Rohini Mathur , Ruth E. Costello , Emily Herrett , Qing Wen , Thomas Hartney , Ian J. Douglas , Amelia Green , Louis Fisher , Laurie Tomlinson

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引用次数: 0

Abstract

Background

COVID-19 severe enough to require hospitalisation is commonly associated with acute kidney injury. However, it remains unclear whether COVID-19 leads to long-term kidney outcomes in the broader population.

Methods

We undertook a population-based, matched cohort study. With the approval of NHS England, we used primary and secondary care electronic health records from England using the OpenSAFELY-TPP platform. We compared people with and without COVID-19 using fully-adjusted, stratified, cause-specific Cox models for kidney failure, 50% reduction in kidney function, and death.

Findings

Overall, all outcomes were increased after COVID-19 over the course of follow-up (HR for kidney failure 1.93 [95% CI 1.84–2.03]). Hazards of kidney failure were greatest after hospitalisation (HR 7.74 [95% CI 7.00–8.56]) and remained increased beyond 180 days of follow-up. There was no evidence of increased risk in those not hospitalised (HR 0.85 [95% CI 0.79–0.90]). Increased kidney failure was more pronounced in black ethnicity (HR 4.50 [95% CI 2.92–6.92]) compared to white ethnicity (HR 1.82 [95% CI 1.71–1.94]). Amongst those hospitalised with COVID-19, there was no attenuation of kidney failure between the first wave (HR 8.74 [95% CI 6.88–11.08]) and the Omicron wave (HR 8.36 [95% CI 6.81–10.27]).

Interpretation

We observed increased long-term kidney outcomes in people hospitalised with COVID-19, as well as notable ethnic differences. Our results suggest strategies to minimise severe COVID-19 should continue to be optimised among vulnerable groups, and that kidney function should be proactively monitored after hospital discharge.

Funding

National Institute for Health and Care Research.

查看原文本刊更多论文

COVID-19后的长期肾脏结局：使用opensafety平台的匹配队列研究

背景：严重到需要住院治疗的covid -19通常与急性肾损伤相关。然而，目前尚不清楚COVID-19是否会在更广泛的人群中导致长期肾脏结局。方法：我们进行了一项基于人群的匹配队列研究。在英国国家医疗服务体系的批准下，我们使用了opensafety - tpp平台上来自英国的初级和二级医疗电子健康记录。我们使用完全调整的、分层的、原因特异性的Cox模型对患有和未患有COVID-19的人进行了比较，这些模型包括肾衰竭、肾功能下降50%和死亡。总体而言，在随访过程中，COVID-19后的所有结局都有所增加（肾衰竭的HR为1.93 [95% CI 1.84-2.03]）。住院后肾衰竭的危险最大（HR 7.74 [95% CI 7.00-8.56]），随访180天后仍在增加。没有证据表明未住院患者的风险增加（HR 0.85 [95% CI 0.79-0.90]）。与白人（HR 1.82 [95% CI 1.71-1.94]）相比，黑人（HR 4.50 [95% CI 2.92-6.92]）肾衰竭增加更为明显。在因COVID-19住院的患者中，在第一波（HR 8.74 [95% CI 6.88-11.08]）和欧米克隆波（HR 8.36 [95% CI 6.81-10.27]）之间，肾衰竭没有减弱。我们观察到COVID-19住院患者的长期肾脏预后增加，以及显著的种族差异。我们的研究结果表明，应继续优化弱势群体中尽量减少严重COVID-19的策略，并在出院后积极监测肾功能。资助国家健康和护理研究所。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Regional Health-Europe Multiple-

CiteScore

19.90

自引率

1.40%

发文量

260

审稿时长

9 weeks

期刊介绍： The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.