Long COVID and kidney disease

Abstract

Kidney involvement is common in patients with acute SARS-CoV-2 infection, and subclinical inflammation and injury may persist for many months, resulting in a progressive decline in kidney function that leads to chronic kidney disease. Continued research is imperative to understand these long-term sequelae and identify interventions to mitigate them.

Fig. 1. Conceptual model of trajectories of kidney function after SARS-CoV-2 infection.

Patients with a high burden of frailty, chronic diseases, disability and immunosenescence are at increased risk of kidney disease and progression to kidney failure, and infection with SARS-CoV-2 can further increase this risk. Kidney function declines gradually over time even in the absence of SARS-CoV-2 infection (1), but patients who are hospitalized with COVID-19 might experience a rapid loss of kidney function resulting in acute kidney injury during the acute phase of the disease (2). Post-infection kidney function trajectories can vary and might include complete recovery (3), as indicated by no change in trajectory compared with patients who are not infected, slow progressive decline owing to subclinical inflammation (4), relapsing or recurrent acute kidney injury and hospitalizations (5) or incomplete recovery and rapidly progressive kidney disease (6). Adapted with permission from ref., Elsevier.