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COVID-19 / SPECIALTY RESEARCH

NephrologyIn perspective.

The key COVID-19 findings in nephrology, distilled into a clear, readable brief. The evidence is here whenever you want to go deeper.

INSIDE THIS MONITOR
33cited sources
16available findings

Study findings updated

AI-assisted evidence summary. For general information. These findings are not individual medical advice or a clinician endorsement.

THE SHORT VERSION

What’s worth knowing.

The key findings, what they mean, and the context that matters.

THE HEADLINE TAKEAWAY17-28%

Acute kidney injury occurred in hospitalized COVID-19 patients

A meta-analysis reported acute kidney injury incidence of 17-28% among hospitalized patients with COVID-19.

This is a pooled incidence in hospitalized patients, not a treatment effect. Timing, patient characteristics and any mortality result are not available in this summary.

See the evidence

Acute Kidney Injury (Hospitalized)

17-28%
Pooled incidence (95% CI: 14.6-25.3%)

Hansrivijit P, Qian C, Boonpheng B, et al. Incidence of acute kidney injury and its association with mortality in patients with COVID-19: a meta-analysis. J Investig Med. 2020;68(7):1261-1270.

02

Higher chronic kidney disease stages tracked with severe COVID-19

172%higher relative hazard

Very high stage chronic kidney disease was associated with a 172% higher relative hazard of severe COVID-19 than low stage disease; moderate and high stages also had higher hazards than low stage disease.

These are pre-pandemic chronic kidney disease associations from the C4R study. Study design, population details and the severe COVID-19 definition are not available in this summary. Relative hazard is not an absolute percentage-point difference.

See the evidence

172% higher relative hazard, calculated from HR 2.72. This is not an absolute percentage-point difference.

Severe COVID-19 risk with very high stage CKD (vs low stage)

HR 2.72
95% CI, 1.88–3.92

Choi, Yuni et al.. Associations of Pre-Pandemic CKD With Acute and Post-Acute COVID-19: The C4R Study.. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2026.

Severe COVID-19 risk with high stage CKD (vs low stage)

HR 2.33
95% CI, 1.77–3.06

Choi, Yuni et al.. Associations of Pre-Pandemic CKD With Acute and Post-Acute COVID-19: The C4R Study.. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2026.

Severe COVID-19 risk with moderate stage CKD (vs low stage)

HR 1.27
95% CI, 1.03–1.56

Choi, Yuni et al.. Associations of Pre-Pandemic CKD With Acute and Post-Acute COVID-19: The C4R Study.. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2026.

03

Chronic kidney disease risk persisted after COVID-19

Chronic kidney disease risk was reported as higher after COVID-19 and persisted beyond 12 months. End-stage kidney disease was also reported as increased.

The population, comparison group and study design are not available in this summary, so the reported relative increases cannot be interpreted as absolute risk differences or causal effects.

See the evidence

Higher risk of chronic kidney disease after COVID-19

35%

Bowe B, Xie Y, Xu E, Al-Aly Z. Kidney Outcomes in Long COVID. J Am Soc Nephrol. 2021;32(11):2851-2862.

End-Stage Kidney Disease

+196%
HR 2.96 (95% CI: 2.49-3.51)

Bowe B, Xie Y, Xu E, Al-Aly Z. Kidney Outcomes in Long COVID. J Am Soc Nephrol. 2021;32(11):2851-2862.

04

More vaccine doses tracked with lower severe COVID-19 hazard

adjusted HR 0.50 per additional vaccine dose

Among adult kidney transplant recipients, the adjusted hazard ratio for severe COVID-19 requiring hospitalization was 0.50 per additional vaccine dose relative to the immediately preceding dose count.

This Australian cohort covered the Delta and Omicron BA.1/BA.2 waves. It reports an adjusted association; further study-design details and absolute hospitalization risks are not available in this summary.

See the evidence

Severe COVID-19 requiring hospitalization among adult kidney transplant recipients during the Delta and Omicron BA.1/BA.2 waves

adjusted HR 0.50 per additional vaccine dose
95% CI: 0.40-0.65

Tharmaraj, Dhakshayini et al.. Critical role of vaccination in preventing severe coronavirus disease 2019: perspectives from clinical outcomes in an Australian kidney transplant recipient cohort.. Internal medicine journal. 2026.

Added

05

Early remdesivir tracked with lower all-cause graft loss

47%lower relative hazard

Versus no remdesivir, early remdesivir was associated with a 47% lower relative hazard of 1-year all-cause graft loss, combining graft failure and all-cause mortality.

Adults were kidney transplant recipients with symptomatic COVID-19; remdesivir began within 7 days and was administered for at least 3 consecutive days. Versus no remdesivir, weighted analyses found no clear difference in all-cause mortality or Long COVID; study design is not available in this summary.

See the evidence

47% lower relative hazard, calculated from HR 0.53. This is not an absolute percentage-point difference.

Among adult kidney transplant recipients with symptomatic COVID-19, early remdesivir initiated within 7 days and administered for at least 3 consecutive days was associated with lower 1-year all-cause graft loss—a composite of graft failure and all-cause mortality—vs no remdesivir after clone-censor-weight adjustment.

HR 0.53
95% CI: 0.31-0.92

Srisurapanont, Karan et al.. Remdesivir and All-Cause Graft Loss Among Kidney Transplant Recipients With Symptomatic COVID-19.. JAMA network open. 2026.

Added

Early remdesivir was not significantly associated with lower all-cause mortality among kidney transplant recipients with symptomatic COVID-19 in the weighted analysis.

HR 0.51
95% CI: 0.24-1.06

Srisurapanont, Karan et al.. Remdesivir and All-Cause Graft Loss Among Kidney Transplant Recipients With Symptomatic COVID-19.. JAMA network open. 2026.

Added

Early remdesivir was not significantly associated with lower long-COVID risk among kidney transplant recipients with symptomatic COVID-19 in the weighted analysis.

HR 0.65
95% CI: 0.21-2.05

Srisurapanont, Karan et al.. Remdesivir and All-Cause Graft Loss Among Kidney Transplant Recipients With Symptomatic COVID-19.. JAMA network open. 2026.

Added

06

Very high chronic kidney disease stage tracked with Long COVID

120%higher relative odds

Very high stage chronic kidney disease was associated with 120% higher relative odds of Long COVID positivity than low stage disease.

The C4R study concerned pre-pandemic kidney disease stage. Its design, population details, follow-up and definition of Long COVID positivity are not available in this summary. Relative odds are not an absolute percentage-point difference.

See the evidence

120% higher relative odds, calculated from OR=2.20. This is not an absolute percentage-point difference.

Long COVID positivity in very high stage CKD (vs low stage)

OR=2.20
95% CI: 1.16–4.18

Choi, Yuni et al.. Associations of Pre-Pandemic CKD With Acute and Post-Acute COVID-19: The C4R Study.. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2026.

Study-specific findings. Different populations, treatments and follow-up periods can produce different results.

THE RESEARCH, AS IT ARRIVES

Latest studies.

The newest findings added to this collection.
The learning from each, already distilled.

  1. STUDY 01Findings added
    TL;DR

    More vaccine doses tracked with lower severe COVID-19 hazard

    adjusted HR 0.50 per additional vaccine dose

    Among adult kidney transplant recipients, the adjusted hazard ratio for severe COVID-19 requiring hospitalization was 0.50 per additional vaccine dose relative to the immediately preceding dose count.

    This Australian cohort covered the Delta and Omicron BA.1/BA.2 waves. It reports an adjusted association; further study-design details and absolute hospitalization risks are not available in this summary.

    Study details & original results

    Tharmaraj, Dhakshayini et al.. Critical role of vaccination in preventing severe coronavirus disease 2019: perspectives from clinical outcomes in an Australian kidney transplant recipient cohort.. Internal medicine journal. 2026.

    Severe COVID-19 requiring hospitalization among adult kidney transplant recipients during the Delta and Omicron BA.1/BA.2 waves

    adjusted HR 0.50 per additional vaccine dose
    95% CI: 0.40-0.65

    Citation in Nephrology
  2. STUDY 02Findings added
    TL;DR

    Early remdesivir tracked with lower graft-loss and cardiovascular hazards

    47%lower relative hazard

    Compared with no remdesivir, early remdesivir was associated with a 47% lower relative hazard of 1-year all-cause graft loss; 1-year cardiovascular event hazard was also lower.

    Adults were kidney transplant recipients with symptomatic COVID-19; remdesivir began within 7 days and was administered for at least 3 consecutive days. Graft loss combined graft failure and all-cause mortality. Results were weight-adjusted; study design is not available in this summary.

    No clear difference

    Mortality and Long COVID differences remained unclear

    Compared with no remdesivir, weighted analyses did not establish lower all-cause mortality or Long COVID risk with early remdesivir.

    This concerned adult kidney transplant recipients with symptomatic COVID-19; remdesivir began within 7 days and was administered for at least 3 consecutive days. No clear difference does not prove equivalence; study design is not available in this summary.

    Study details & original results

    Srisurapanont, Karan et al.. Remdesivir and All-Cause Graft Loss Among Kidney Transplant Recipients With Symptomatic COVID-19.. JAMA network open. 2026.

    Among adult kidney transplant recipients with symptomatic COVID-19, early remdesivir initiated within 7 days and administered for at least 3 consecutive days was associated with lower 1-year all-cause graft loss—a composite of graft failure and all-cause mortality—vs no remdesivir after clone-censor-weight adjustment.

    HR 0.53
    95% CI: 0.31-0.92

    Among adult kidney transplant recipients with symptomatic COVID-19, early remdesivir was associated with lower 1-year cardiovascular event risk vs no remdesivir after clone-censor-weight adjustment.

    HR 0.58
    95% CI: 0.35-0.98

    47% lower relative hazard, calculated from HR 0.53. This is not an absolute percentage-point difference.

    Citation in Nephrology

    Early remdesivir was not significantly associated with lower all-cause mortality among kidney transplant recipients with symptomatic COVID-19 in the weighted analysis.

    HR 0.51
    95% CI: 0.24-1.06

    Early remdesivir was not significantly associated with lower long-COVID risk among kidney transplant recipients with symptomatic COVID-19 in the weighted analysis.

    HR 0.65
    95% CI: 0.21-2.05

    Among adult kidney transplant recipients with symptomatic COVID-19, early remdesivir initiated within 7 days and administered for at least 3 consecutive days was associated with lower 1-year all-cause graft loss—a composite of graft failure and all-cause mortality—vs no remdesivir after clone-censor-weight adjustment.

    HR 0.53
    95% CI: 0.31-0.92

    The reported result does not establish a difference; it does not prove equivalence.

    Citation in Nephrology
2 of 2 study updates

Dates show when findings were added here, not when papers were published. Study populations and comparisons differ.

WHEN YOU WANT TO GO DEEPER
See all 16 findingsOriginal results, comparisons and study details.
5 of 5 source groupsFindings stay together with their study.
SOURCE 331 finding

Tharmaraj, Dhakshayini et al.. Critical role of vaccination in preventing severe coronavirus disease 2019: perspectives from clinical outcomes in an Australian kidney transplant recipient cohort.. Internal medicine journal. 2026.

Severe COVID-19 requiring hospitalization among adult kidney transplant recipients during the Delta and Omicron BA.1/BA.2 waves

Added
adjusted HR 0.50 per additional vaccine dose95% CI: 0.40-0.65Source [33]
SOURCE 324 findings

Srisurapanont, Karan et al.. Remdesivir and All-Cause Graft Loss Among Kidney Transplant Recipients With Symptomatic COVID-19.. JAMA network open. 2026.

Among adult kidney transplant recipients with symptomatic COVID-19, early remdesivir initiated within 7 days and administered for at least 3 consecutive days was associated with lower 1-year all-cause graft loss—a composite of graft failure and all-cause mortality—vs no remdesivir after clone-censor-weight adjustment.

Added
HR 0.5395% CI: 0.31-0.92Source [32]

Among adult kidney transplant recipients with symptomatic COVID-19, early remdesivir was associated with lower 1-year cardiovascular event risk vs no remdesivir after clone-censor-weight adjustment.

Added
HR 0.5895% CI: 0.35-0.98Source [32]
All 4 findings from this source

Early remdesivir was not significantly associated with lower all-cause mortality among kidney transplant recipients with symptomatic COVID-19 in the weighted analysis.

Added
HR 0.5195% CI: 0.24-1.06Source [32]

Early remdesivir was not significantly associated with lower long-COVID risk among kidney transplant recipients with symptomatic COVID-19 in the weighted analysis.

Added
HR 0.6595% CI: 0.21-2.05Source [32]
SOURCE 013 findings

Bowe B, Xie Y, Xu E, Al-Aly Z. Kidney Outcomes in Long COVID. J Am Soc Nephrol. 2021;32(11):2851-2862.

Chronic Kidney Disease

+35%HR 1.35 (95% CI: 1.31-1.39)Source [1]

eGFR Decline >30%

+62%HR 1.62 (95% CI: 1.51-1.74)Source [1]
All 3 findings from this source

End-Stage Kidney Disease

+196%HR 2.96 (95% CI: 2.49-3.51)Source [1]
SOURCE 091 finding

Hansrivijit P, Qian C, Boonpheng B, et al. Incidence of acute kidney injury and its association with mortality in patients with COVID-19: a meta-analysis. J Investig Med. 2020;68(7):1261-1270.

Acute Kidney Injury (Hospitalized)

17-28%Pooled incidence (95% CI: 14.6-25.3%)Source [9]
SOURCE 317 findings

Choi, Yuni et al.. Associations of Pre-Pandemic CKD With Acute and Post-Acute COVID-19: The C4R Study.. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2026.

Severe COVID-19 risk with moderate stage CKD (vs low stage)

HR 1.2795% CI, 1.03–1.56Source [31]

Severe COVID-19 risk with high stage CKD (vs low stage)

HR 2.3395% CI, 1.77–3.06Source [31]
All 7 findings from this source

Severe COVID-19 risk with very high stage CKD (vs low stage)

HR 2.7295% CI, 1.88–3.92Source [31]

Reduction in anti-S1 IgG levels with moderate stage CKD

−12.00%95% CI: −21.14% to −1.78%Source [31]

Reduction in anti-S1 IgG levels with high stage CKD

−27.03%95% CI, −40.00% to −11.25%Source [31]

Reduction in anti-S1 IgG levels with very high stage CKD

−48.9%95% CI, −61.60% to −32.01%Source [31]

Long COVID positivity in very high stage CKD (vs low stage)

OR=2.2095% CI: 1.16–4.18Source [31]
Browse the 33 original sourcesThe complete bibliography behind this monitor.
  1. [1]

    Bowe B, Xie Y, Xu E, Al-Aly Z. Kidney Outcomes in Long COVID. J Am Soc Nephrol. 2021;32(11):2851-2862.

    Open original source in a new tab
  2. [2]

    Bowe B, Xie Y, Al-Aly Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nat Med. 2022;28(11):2398-2405.

    Open original source in a new tab
  3. [3]

    Hirsch JS, Ng JH, Ross DW, et al. Acute kidney injury in patients hospitalized with COVID-19. Kidney Int. 2020;98(1):209-218.

    Open original source in a new tab
  4. [4]

    Gupta S, Coca SG, Chan L, et al. AKI Treated with Renal Replacement Therapy in Critically Ill Patients with COVID-19. J Am Soc Nephrol. 2021;32(1):161-176.

    Open original source in a new tab
  5. [5]

    Robbins-Juarez SY, Qian L, King KL, et al. Outcomes for Patients With COVID-19 and Acute Kidney Injury: A Systematic Review and Meta-Analysis. Kidney Int Rep. 2020;5(8):1149-1160.

    Open original source in a new tab
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    Puelles VG, Lutgehetmann M, Lindenmeyer MT, et al. Multiorgan and Renal Tropism of SARS-CoV-2. N Engl J Med. 2020;383(6):590-592.

    Open original source in a new tab
  7. [7]

    Kudose S, Batal I, Santoriello D, et al. Kidney Biopsy Findings in Patients with COVID-19. J Am Soc Nephrol. 2020;31(9):1959-1968.

    Open original source in a new tab
  8. [8]

    Charytan DM, Parnia S, Engelman ZJ, et al. Tubular injury in COVID-19-associated AKI. J Am Soc Nephrol. 2021;32(11):2820-2834.

    Open original source in a new tab
  9. [9]

    Hansrivijit P, Qian C, Boonpheng B, et al. Incidence of acute kidney injury and its association with mortality in patients with COVID-19: a meta-analysis. J Investig Med. 2020;68(7):1261-1270.

    Open original source in a new tab
  10. [10]

    Silver SA, Beaubien-Souligny W, Shah PS, et al. The Prevalence of Acute Kidney Injury in Patients Hospitalized With COVID-19 Infection: A Systematic Review and Meta-analysis. Kidney Med. 2021;3(1):83-98.e1.

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    Gabarre P, Dumas G, Dupont T, et al. Acute kidney injury in critically ill patients with COVID-19. Intensive Care Med. 2020;46(7):1339-1348.

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    Farouk SS, Fiaccadori E, Cravedi P, Campbell KN. COVID-19 and the kidney: what we think we know so far and what we don't. J Nephrol. 2020;33(6):1213-1218.

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    Chan L, Chaudhary K, Saha A, et al. AKI in Hospitalized Patients with COVID-19. J Am Soc Nephrol. 2021;32(1):151-160.

    Open original source in a new tab
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    Nugent J, Aklilu A, Engelman ZJ, et al. Assessment of Acute Kidney Injury and Longitudinal Kidney Function After Hospital Discharge Among Patients With and Without COVID-19. JAMA Netw Open. 2021;4(3):e211095.

    Open original source in a new tab
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    Cravedi P, Mothi SS, Azzi Y, et al. COVID-19 and kidney transplantation: Results from the TANGO International Transplant Consortium. Am J Transplant. 2020;20(11):3140-3148.

    Open original source in a new tab
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    ERA-EDTA Council; ERACODA Working Group. Chronic kidney disease is a key risk factor for severe COVID-19: a call to action by the ERA-EDTA. Nephrol Dial Transplant. 2021;36(1):87-94.

    Open original source in a new tab
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    STOP-COVID Investigators. Risk factors for in-hospital mortality from COVID-19 infection among Black patients. Kidney Int. 2021;99(6):1479-1491.

    Open original source in a new tab
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    Wysocki J, Ye M, Hassler L, et al. A Novel Soluble ACE2 Variant with Prolonged Duration of Action Neutralizes SARS-CoV-2 Infection in Human Kidney Organoids. J Am Soc Nephrol. 2021;32(4):795-803.

    Open original source in a new tab
  19. [19]

    Nadim MK, Forni LG, Mehta RL, et al. COVID-19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup. Nat Rev Nephrol. 2020;16(12):747-764.

    Open original source in a new tab
  20. [20]

    Moledina DG, Simonov M, Yamamoto Y, et al. The Association of COVID-19 with Acute Kidney Injury Independent of Severity of Illness: A Multicenter Cohort Study. Am J Kidney Dis. 2021;77(4):490-499.e1.

    Open original source in a new tab
  21. [21]

    Lopes RD, Macedo AVS, de Barros E Silva PGM, et al. Effect of Discontinuing vs Continuing Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on Days Alive and Out of the Hospital in Patients Admitted With COVID-19: A Randomized Clinical Trial (BRACE-CORONA). JAMA. 2021;325(3):254-264.

    Open original source in a new tab
  22. [22]

    STARRT-AKI Investigators. Timing of Initiation of Renal-Replacement Therapy in Acute Kidney Injury. N Engl J Med. 2020;383(3):240-251.

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    Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl. 2012;2:1-138.

    Open original source in a new tab
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    American Society of Nephrology. Recommendations on the Care of Hospitalized Patients with COVID-19 and Kidney Failure Requiring Renal Replacement Therapy. 2020.

    Original source link unavailable
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    Parikh CR, Coca SG. The Long-Term Kidney Consequences of COVID-19. Nat Rev Nephrol. 2022;18(7):417-418.

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    Batlle D, Soler MJ, Sparks MA, et al. Acute Kidney Injury in COVID-19: Emerging Evidence of a Distinct Pathophysiology. J Am Soc Nephrol. 2020;31(7):1380-1383.

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    Ronco C, Reis T, Husain-Syed F. Management of acute kidney injury in patients with COVID-19. Lancet Respir Med. 2020;8(7):738-742.

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    Velez JCQ, Caza T, Larsen CP. COVAN is the new HIVAN: the re-emergence of collapsing glomerulopathy with COVID-19. Nat Rev Nephrol. 2020;16(10):565-567.

    Open original source in a new tab
  29. [29]

    Legrand M, Bell S, Forni L, et al. Pathophysiology of COVID-19-associated acute kidney injury. Nat Rev Nephrol. 2021;17(11):751-764.

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  30. [30]

    Gupta S, Hayek SS, Wang W, et al. Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US. JAMA Intern Med. 2020;180(11):1436-1447.

    Open original source in a new tab
  31. [31]

    Choi, Yuni et al.. Associations of Pre-Pandemic CKD With Acute and Post-Acute COVID-19: The C4R Study.. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2026.

    Open original source in a new tab
  32. [32]

    Srisurapanont, Karan et al.. Remdesivir and All-Cause Graft Loss Among Kidney Transplant Recipients With Symptomatic COVID-19.. JAMA network open. 2026.

    Open original source in a new tab
  33. [33]

    Tharmaraj, Dhakshayini et al.. Critical role of vaccination in preventing severe coronavirus disease 2019: perspectives from clinical outcomes in an Australian kidney transplant recipient cohort.. Internal medicine journal. 2026.

    Open original source in a new tab
ABOUT THIS MONITOR

Understanding includes the limits.

This is an AI-assisted evidence summary, not a clinician endorsement. Read each original paper for its complete methods, population and limitations. Different studies can ask different questions and report different kinds of results.

Dates marked “added” describe when a finding entered this monitor, not when the study was published or clinically reviewed. Personal health and treatment decisions belong in a conversation with a qualified clinician.

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