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, 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,

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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
DOIs
Publication statusPublished - May 2024

Keywords

  • Chronic kidney disease
  • Dialysis
  • immunocompromised
  • Kidney transplant recipient
  • Long-COVID
  • Post COVID-19 condition
  • Solid organ transplant recipient

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