Kidney function of survivors from COVID-19 hospitalization: potential implications of musculoskeletal health

• Grant number: 24/04564-0
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Start date: June 01, 2024
• End date: May 21, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Carlos Roberto Ribeiro de Carvalho
• Grantee: Heitor Siqueira Ribeiro
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated research grant: 22/01769-5 - Late assessment of physical, psychological and cognitive effects in a cohort of patients surviving COVID-19 hospitalization at a tertiary university hospital: a multidisciplinary approach, AP.TEM

Abstract

Patients surviving hospitalization for moderate and severe COVID-19 have long-term sequelae in multiple organs. Kidney function has been shown to be affected and declines are expected, however, the risk factors are unknown, as well as the progression to chronic kidney disease (CKD). Musculoskeletal health, particularly muscle strength, has been suggested as a potential predictor of CKD progression in people already living with kidney disease and with CKD without COVID-19. Objectives: To investigate the association of musculoskeletal health with the incidence and/or progression of CKD in patients surviving hospitalization for moderate and severe COVID-19. Compare the assessment of glomerular filtration by cystatin c and creatinine in these patients. Methods: Prospective cohort study with adults (e 18 years old) hospitalized with a diagnosis of COVID-19 at the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo from March to August 2020 and who survived hospitalization for more than six months. All eligible individuals (1,957) were invited to participate and 749 accepted. Those included underwent a series of multidisciplinary assessments at six to nine, 12 to 15 and 24 to 27 months after discharge. Renal function will be estimated using glomerular filtration rate according to the race-free CKD-EPI formula. CKD will be defined according to the KDIGO guideline: eGFR <60 ml/min/1.37m2 and/or albuminuria (AER e30 mg/24 hours; ACR e30 mg/g [e3 mg/mmol]) that is maintain these parameters between follow-up assessments (>3 months). Musculoskeletal health was assessed using handgrip strength test, one minute sit-to-stand, 10 meters usual gait speed and arm and calf circumferences. Cytokines associated with inflammatory and myogenic markers of the musculoskeletal mass (myokines) will be measured. Linear and Cox regression analyzes will verify possible associations between musculoskeletal health and the incidence and/or progression of CKD. Expected results: It is expected to identify that musculoskeletal health is associated with the incidence and/or progression of CKD in survivors of hospitalization for moderate and severe COVID-19. Therapeutic implications: If the expected results are confirmed, interventions with exercise and nutrition will be designed to potentially induce improvements in the musculoskeletal health of survivors of hospitalization for COVID-19 and, thus, mitigate the impacts on kidney function in the long term. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

RIBEIRO, HEITOR S.; BURDMANN, EMMANUEL A.; YU, LUIS. Renal long COVID-19: an ongoing debate requiring robust evidence. J. Bras. Nefrol., v. 47, n. 3, p. 4-pg., 2025-01-01. (24/04564-0)