LATEBREAKER
COVID-19 Pandemic
Does COVID-19 Increase the Risk of Subsequent Kidney Diseases More Than Influenza? A Retrospective Cohort Study Using Real-World Data Yue Zhang* Yue Zhang Nasrollah Ghahramani Vernon Chinchilli Djibril Ba
Background: Although case reports and observational studies suggest COVID-19 increases the risk of kidney diseases, definitive real-world evidence, especially in comparison with influenza, is lacking. Our study aims to assess the association between COVID-19 infections and subsequent kidney diseases, using influenza as a positive control and incorporating a negative control to establish clearer associations.
Methods: A large retrospective cohort study with strata matching was conducted using the MarketScan database with records from Jan. 2020 to Dec. 2021. We used the international classification of 10th revision (ICD-10) codes to identify individuals and build three cohorts, COVID-19, Influenza but no COVID-19 (positive control), and no COVID-19 / Influenza (negative control). The main outcomes were acute kidney injury (AKI), and chronic kidney disease (CKD). To evaluate the association between COVID-19 and the onset of kidney diseases relative to both control groups, we employed multivariable stratified Cox proportional hazards regression analysis.
Results: The study included 939,241 individuals with COVID-19, 1,878,482 individuals in the negative control group, and 199,071 individuals with influenza. After adjusting for demographics, comorbidities, and medication histories, COVID-19 was significantly associated with increased risks of AKI (HR: 2.75, 2.62-2.88) and CKD (HR: 1.38, 1.32-1.45), while influenza was associated with a modestly increased risk of AKI (HR: 1.23, 1.10-1.37) and had no impact on CKD (HR: 1.03, 0.92-1.14). Time-specific analyses indicated that while the HR for AKI declined from 0-180 days to 0-540 days, CKD’s HR remained stable, with COVID-19’s risk surpassing influenza’s throughout follow-up (Figure).
Conclusion: COVID-19 infections were associated with a 2.4-fold risk of developing AKI and a 1.4-fold risk of CKD as compared to influenza. Greater attention needs to be paid to AKI and CKD in individuals after contracting COVID-19.
