Post COVID-19 condition imposes significant burden in patients with advanced chronic kidney disease: A nested case-control study

Pim Bouwmans, S Reshwan K Malahe, A Lianne Messchendorp, RECOVAC Consortium / RECOVAC Collaborators, Priya Vart, Céline Imhof, Jan-Stephan F Sanders, Ron T Gansevoort, Aiko P J de Vries, Alferso C Abrahams, Frederike J Bemelman, Johanna P M Vervoort, Luuk B Hilbrands, Marc A G J Ten Dam, René M A van den Dorpel, Theo Rispens, Maurice Steenhuis, Marlies E J Reinders, Marc H Hemmelder

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Abstract

Background: 

The burden of post COVID-19 condition (PCC) is not well studied in patients with advanced kidney disease. 

Methods: 

A large prospective cohort of SARS-CoV-2 vaccinated patients with chronic kidney disease stages G4–G5 (CKD G4/5), on dialysis, and kidney transplant recipients (KTR) were included. Antibody levels were determined after vaccination. Presence of long-lasting symptoms was assessed in patients with and without prior COVID-19 and compared using logistic regression. In patients with prior COVID-19, PCC was defined according to the WHO definition. 

Results: 

Two hundred sixteen CKD G4/5 patients, 375 dialysis patients, and 2005 KTR were included. Long-lasting symptoms were reported in 204/853 (24%) patients with prior COVID-19 and in 297/1743 (17%) patients without prior COVID-19 (aOR: 1.45 (1.17–1.78)], P < 0.001). PCC was prevalent in 29% of CKD G4/5 patients, 21% of dialysis patients, and 24% of KTR. In addition, 69% of patients with PCC reported (very) high symptom burden. Odds of PCC was lower per 10-fold increase in antibody level after vaccination (aOR 0.82 [0.70–0.96], P = 0.01) and higher in case of COVID-19 related hospital admission (aOR 4.64 [2.61–8.25], P = 0.003). 

Conclusions: 

CKD G4/5 patients, dialysis patients, and KTR are at risk for PCC with high symptom burden after SARS-CoV-2 vaccination, especially if antibody levels are low and in case of hospitalization due to COVID-19.

Original languageEnglish
Article number106990
JournalInternational Journal of Infectious Diseases
Volume142
Early online date28 Feb 2024
DOIs
Publication statusPublished - May 2024

Bibliographical note

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

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