COVID-19 Accelerates Kidney Function Decline in Transplant Patients Even Four Years After Infection
Nikhil Prasad Fact checked by:Thailand Medical News Team Apr 26, 2025 4 days, 18 hours, 38 minutes ago
Medical News: A new study by researchers from the Albert Einstein College of Medicine and Montefiore Medical Center in New York has revealed that COVID-19 can significantly worsen kidney function in transplant patients for up to four years after infection. This
Medical News report sheds light on long-term risks facing kidney transplant recipients (KTRs), a group already vulnerable due to lifelong immunosuppression.
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COVID-19 Accelerates Kidney Function Decline in Transplant Patients Even Four Years After Infection
The research is among the first to track chronic kidney health post-COVID in KTRs and compared outcomes between patients who had contracted SARS-CoV-2 and those who had not. Despite no difference in long-term mortality between the two groups, the study found that those who had recovered from COVID-19 experienced a noticeably faster decline in kidney function, as measured by estimated glomerular filtration rate (eGFR)—a key indicator of how well the kidneys filter waste from the blood.
Tracking Four Years of Kidney Decline
The researchers studied the medical records of 1,815 kidney transplant patients from 2001 to early 2024. They focused on 510 patients who had survived COVID-19 and matched them with 510 transplant patients who never tested positive. The team examined changes in eGFR and urine protein levels, mortality rates, and biopsy-confirmed organ rejection over four years.
Before contracting COVID-19, both groups had similar rates of eGFR decline, at about 0.98 units per year. After infection, however, the COVID-19 group saw their kidney function deteriorate nearly twice as fast, at 1.80 units per year. This decline was especially noticeable in male patients.
Interestingly, no significant difference was found in urine protein levels (another indicator of kidney stress), and COVID-19 infection was not linked to an increase in organ rejection. Additionally, while the COVID-19 group had a slightly higher rate of pre-existing conditions like diabetes and cardiovascular disease, this did not fully explain the rapid deterioration in kidney function.
Sex Matters in Kidney Outcomes
The study found a striking difference based on sex. Only male kidney transplant patients showed significant post-COVID declines in eGFR. Female transplant recipients did not experience the same level of deterioration, suggesting a possible protective effect of female biology or different inflammatory responses.
This finding adds to a growing body of research showing that men and women often respond differently to COVID-19 and its long-term effects. It also raises questions about how hormonal or genetic factors might influence kidney resilience in transplant patients.
Why COVID Worsens Kidney Function
The researchers believe several biological processes may be behind the post-COVID kidney damage. During the acute phase of infection, SARS-CoV-2 can cause an overwhelming immune response, inflammation, and clotting issues—all o
f which can damage organs, including transplanted kidneys. Some of this damage may linger or set off slow, progressive injury long after the virus is gone.
Persistent low-grade inflammation, immune system disruptions, and even microclots in kidney blood vessels could all play roles in the observed decline. The stress COVID-19 puts on the lungs and heart can also reduce oxygen supply to the kidneys, causing tissue damage that is hard to reverse.
What This Means for Transplant Patients
Kidney transplant recipients already live with elevated health risks, and this study underscores how COVID-19 adds another layer of danger. Even after recovering from the virus, these patients may be silently losing kidney function faster than before. The researchers recommend long-term monitoring of kidney performance and caution that even asymptomatic or mild COVID-19 cases could pose long-term risks for this group.
Medical teams may need to adapt treatment plans—such as modifying immunosuppressive therapy or using anti-inflammatory strategies—to help preserve kidney function in these patients after COVID-19. More research is needed to explore such interventions and to determine whether COVID-19 vaccines or antiviral treatments like Remdesivir could influence long-term outcomes.
Conclusions
This groundbreaking study confirms that SARS-CoV-2 infection is associated with a significantly accelerated decline in kidney function among transplant recipients, especially men, lasting up to four years post-infection. While COVID-19 did not increase long-term mortality or proteinuria in this cohort, the progressive loss of kidney function may lead to serious complications over time. These findings highlight the importance of vigilant kidney monitoring and personalized care strategies for kidney transplant recipients recovering from COVID-19. The results also call for continued research into mechanisms of post-COVID organ damage and the development of interventions to slow or prevent long-term decline.
The study findings were published in the peer reviewed journal: Diagnostics.
https://www.mdpi.com/2075-4418/15/9/1091
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