PDF(Pubmed)
Abstract：
UNASSIGNED: Previous research indicates that coronavirus disease 2019 (COVID-19) infection may have a role in triggering immunoglobulin A (IgA) nephropathy. However, limited research has explored the clinical implications of COVID-19 infection in individuals already diagnosed with IgA nephropathy. This study aimed to determine whether COVID-19 infection independently affects the subsequent trajectory of kidney function in IgA nephropathy patients.
UNASSIGNED: This was a single-center cohort study. The study included 199 patients diagnosed with IgA nephropathy. The COVID-19 infection status was determined using a combined method: a questionnaire and the Health Code application, both administered at the end of 2022 in northern China. Kidney function trajectory was assessed by the estimated glomerular filtration rate (eGFR), calculated based on serum creatinine levels measured during follow-up outpatient visits. The primary endpoint of interest was the eGFR trajectory.
UNASSIGNED: Out of the 199 participants, 75% (n = 181) reported a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, determined through antigen or polymerase chain reaction tests, accounting for 79% (n = 143) of the infected patients. A significant majority (98%) experienced mild to moderate symptoms. Over a median follow-up period of 10.7 months post-COVID-19 infection, notable clinical events included gross hematuria in 30 patients (16.6%), which normalized within an average of 3 days. Additionally, a 2-fold increase in proteinuria or progression to the nephrotic range was observed in 10 individuals (5.5%). No cases of acute kidney injury were noted. COVID-19 exposure was associated with an absolute change in eGFR of 2.98 mL/min/1.73 m2 per month (95% confidence interval 0.46 to 5.50). However, in a fully adjusted model, the estimated changes in eGFR slope post-COVID-19 were -0.39 mL/min/1.73 m2 per month (95% confidence interval -0.83 to 0.06, P = .088) which included the possibility of no significant effect. Notably, a higher rate of kidney function decline was primarily observed in patients with a baseline eGFR <45 mL/min/1.73 m2 [-0.56 mL/min/1.73 m2 (-1.11 to -0.01), P = .048]. In the cohort, there were few instances of severe COVID-19 cases. The absence of long-term follow-up outcomes was observed.
UNASSIGNED: Overall, mild to moderate COVID-19 infection does not appear to significantly exacerbate the subsequent decline in kidney function among IgA nephropathy patients, particularly in those with preserved baseline kidney function.
UNASSIGNED: This was a single-center cohort study. The study included 199 patients diagnosed with IgA nephropathy. The COVID-19 infection status was determined using a combined method: a questionnaire and the Health Code application, both administered at the end of 2022 in northern China. Kidney function trajectory was assessed by the estimated glomerular filtration rate (eGFR), calculated based on serum creatinine levels measured during follow-up outpatient visits. The primary endpoint of interest was the eGFR trajectory.
UNASSIGNED: Out of the 199 participants, 75% (n = 181) reported a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, determined through antigen or polymerase chain reaction tests, accounting for 79% (n = 143) of the infected patients. A significant majority (98%) experienced mild to moderate symptoms. Over a median follow-up period of 10.7 months post-COVID-19 infection, notable clinical events included gross hematuria in 30 patients (16.6%), which normalized within an average of 3 days. Additionally, a 2-fold increase in proteinuria or progression to the nephrotic range was observed in 10 individuals (5.5%). No cases of acute kidney injury were noted. COVID-19 exposure was associated with an absolute change in eGFR of 2.98 mL/min/1.73 m2 per month (95% confidence interval 0.46 to 5.50). However, in a fully adjusted model, the estimated changes in eGFR slope post-COVID-19 were -0.39 mL/min/1.73 m2 per month (95% confidence interval -0.83 to 0.06, P = .088) which included the possibility of no significant effect. Notably, a higher rate of kidney function decline was primarily observed in patients with a baseline eGFR <45 mL/min/1.73 m2 [-0.56 mL/min/1.73 m2 (-1.11 to -0.01), P = .048]. In the cohort, there were few instances of severe COVID-19 cases. The absence of long-term follow-up outcomes was observed.
UNASSIGNED: Overall, mild to moderate COVID-19 infection does not appear to significantly exacerbate the subsequent decline in kidney function among IgA nephropathy patients, particularly in those with preserved baseline kidney function.
摘要：
■先前的研究表明，2019年冠状病毒病（COVID-19）感染可能在引发免疫球蛋白A（IgA）肾病中起作用。然而,有限的研究探索了COVID-19感染在已诊断为IgA肾病的个体中的临床意义.这项研究旨在确定COVID-19感染是否独立影响IgA肾病患者随后的肾功能轨迹。
■这是一项单中心队列研究。该研究包括199例诊断为IgA肾病的患者。COVID-19感染状况是使用一种组合方法确定的：问卷调查和健康代码应用程序，两者均于2022年底在中国北方实施。通过估计的肾小球滤过率（eGFR）评估肾功能轨迹，根据门诊随访期间测量的血清肌酐水平计算。感兴趣的主要终点是eGFR轨迹。
■在199名参与者中，75％（n=181）报告了确诊的严重急性呼吸道综合症冠状病毒2（SARS-CoV-2）感染，通过抗原或聚合酶链反应试验确定，占感染患者的79%(n=143)。绝大多数（98％）出现轻度至中度症状。在COVID-19感染后10.7个月的中位随访期，显著的临床事件包括30例患者的肉眼血尿(16.6%),在平均3天内恢复正常。此外,在10例患者(5.5%)中观察到蛋白尿增加2倍或进展至肾病范围.未发现急性肾损伤病例。COVID-19暴露与eGFR每月2.98mL/min/1.73m2的绝对变化相关（95％置信区间0.46至5.50）。然而,在一个完全调整的模型中，COVID-19后eGFR斜率的估计变化为-0.39mL/min/1.73m2/月(95%置信区间-0.83~0.06,P=0.088),其中包括无显著影响的可能性.值得注意的是,在基线eGFR<45mL/min/1.73m2[-0.56mL/min/1.73m2（-1.11至-0.01）的患者中，主要观察到较高的肾功能下降率。P=.048]。在队列中，严重COVID-19病例很少。观察到没有长期随访结果。
■总的来说，轻度至中度COVID-19感染似乎不会显着加剧IgA肾病患者随后的肾功能下降，特别是那些保留基线肾功能的患者。
■这是一项单中心队列研究。该研究包括199例诊断为IgA肾病的患者。COVID-19感染状况是使用一种组合方法确定的：问卷调查和健康代码应用程序，两者均于2022年底在中国北方实施。通过估计的肾小球滤过率（eGFR）评估肾功能轨迹，根据门诊随访期间测量的血清肌酐水平计算。感兴趣的主要终点是eGFR轨迹。
■在199名参与者中，75％（n=181）报告了确诊的严重急性呼吸道综合症冠状病毒2（SARS-CoV-2）感染，通过抗原或聚合酶链反应试验确定，占感染患者的79%(n=143)。绝大多数（98％）出现轻度至中度症状。在COVID-19感染后10.7个月的中位随访期，显著的临床事件包括30例患者的肉眼血尿(16.6%),在平均3天内恢复正常。此外,在10例患者(5.5%)中观察到蛋白尿增加2倍或进展至肾病范围.未发现急性肾损伤病例。COVID-19暴露与eGFR每月2.98mL/min/1.73m2的绝对变化相关（95％置信区间0.46至5.50）。然而,在一个完全调整的模型中，COVID-19后eGFR斜率的估计变化为-0.39mL/min/1.73m2/月(95%置信区间-0.83~0.06,P=0.088),其中包括无显著影响的可能性.值得注意的是,在基线eGFR<45mL/min/1.73m2[-0.56mL/min/1.73m2（-1.11至-0.01）的患者中，主要观察到较高的肾功能下降率。P=.048]。在队列中，严重COVID-19病例很少。观察到没有长期随访结果。
■总的来说，轻度至中度COVID-19感染似乎不会显着加剧IgA肾病患者随后的肾功能下降，特别是那些保留基线肾功能的患者。
