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Clin Exp Med . Risk factors for severe COVID-19 infection and the impact of COVID-19 infection on disease progression among patients with AAV

tetano

Editor, Senior Moderator
Clin Exp Med


. 2024 Apr 29;24(1):88.
doi: 10.1007/s10238-024-01351-x. Risk factors for severe COVID-19 infection and the impact of COVID-19 infection on disease progression among patients with AAV

Chen Wang[SUP] 1 2 3 [/SUP], Zhi-Ying Li[SUP] 1 2 3 [/SUP], Gui-Ping Jiang[SUP] 4 [/SUP], Ming-Hui Zhao[SUP] 1 2 3 5 [/SUP], Min Chen[SUP] 6 7 8 [/SUP]



Affiliations
Abstract

To identify risk factors for COVID-19 infection and investigate the impact of COVID-19 infection on chronic kidney disease (CKD) progression and vasculitis flare in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). This cohort study retrospectively analyzed the prevalence and severity of COVID-19 infection in 276 patients with AAV who were followed up. Logistic regression was employed to estimate the risk of COVID-19 infection as well as CKD progression and vasculitis flare upon COVID-19 infection. During the 6-month observation period, 213 (77.2%) of 276 patients were diagnosed with COVID-19 infection. Of these 213 patients, 49 (23.0%) had a COVID-19-related inpatient admission, including 17 patients who died of COVID-19 infection. AAV patients with severe COVID-19 infection were more likely to be male (OR 1.921 [95% CI 1.020-3.619], P = 0.043), suffered from worse kidney function (serum creatinine [Scr], OR 1.901 [95% CI 1.345-2.687], P < 0.001), had higher C-reactive protein (CRP) (OR 1.054 [95% CI 1.010-1.101], P = 0.017) and less likely to have evidence of initial vaccination (OR 0.469 [95% CI 0.231-0.951], P = 0.036), and Scr and COVID-19 vaccination were proven to be significantly associated with severe COVID-19 infection even after multivariable adjustment. Severe COVID-19 infection was significantly associated with subsequent CKD progression (OR 7.929 [95% CI 2.030-30.961], P = 0.003) and vasculitis flare (OR 11.842 [95% CI 1.048-133.835], P = 0.046) among patients with AAV. AAV patients who were male, and with worse kidney function were more susceptible to severe COVID-19 infection, which subsequently increased the risk of CKD progression and vasculitis flare.

Keywords: ANCA; COVID-19; Flare; Vasculitis.

 
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