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Correspondence to Author: Elena Jordanova¹ , Ana Račić Ostojić ¹ , Tamara Jemcov ^1,9, Svetlana Krsmanović ² , Violeta Rabrenović ³ , Milica Petrović ³ , Marija Dobričić ⁴ , Dragana Stanković Tošković ⁵ , Svetlana Petrović ⁵ , Sanja Simić Ogrizović ⁶ , Verica Pajić ⁷ , Marijana Kovačević ⁸ , Ljubica Djukanovic^9,10, Visnja Ležaić^9,10. 

1. Nephrology Department, Zemun Clinical Hospital Center, Zemun-Belgrade,Serbia, Email: [email protected] (EJ), [email protected] (ARO), [email protected] (TJ),
2. Nephrology Ward, Health Center, Priboj,Serbia. Email: [email protected] (SK),
3. Military Medical Academy, Clinic of Nephrology, Belgrade,Serbia. Email: [email protected] (VR), [email protected] (MP),
4. Special Hospital for Internal Diseases, Lazarevac,Serbia. Email: [email protected] (MD),
5. General Hospital “dr Laza K. Lazarevic” Sabac,Serbia. Email: [email protected] (DST), [email protected] (SP),
6. Medigroup General Hospital, Belgrade,Serbia. Email: [email protected] (SSO)
7. General Hospital “Dr Voja Dulic”, Dialysis Unit, Pozarevac,Serbia. Email: [email protected] (VP),
8. University of East Sarajevo, Faculty of Medicine, Foča, Bosnia and Herzegovina. Email: [email protected] (MK),
9. Medical Faculty, Belgrade University,
10. Academy of Medical Sciences of Serbia Medical Society, Belgrade,Serbia. Email: [email protected] (Lj Dj), visnjalezaic@gma

DOI: 10.52338/tjocm.2026.5308

Abstract:

Background:The chronic consequences of COVID-19 in patients with pre-existing chronic kidney disease (CKD) remain a global concern, particularly in low- and middle-income countries where healthcare resources are limited. This study evaluated the long-term effects of SARSCoV-2 infection on CKD progression over 36 months.
Methods: In this multicenter retrospective study, 58 CKD patients with confirmed SARS-CoV-2 infection (COVID-positive) were compared with 54 CKD patients without a history of infection (COVID-negative), matched for age, sex, and timing of follow-up recruited from eight nephrology institutions. Clinical and laboratory data, comorbidities, and vaccination status were analyzed. Kidney function was assessed by annual estimated glomerular filtration rate (eGFR) slope.
Results: COVID-positive patients showed a significantly greater median annual eGFR decline than COVID negative ones (−4.0 vs. −1.5 ml/ min/1.73 m², P = 0.005). Furthermore, the proportion of rapid progression was significantly higher in the COVID-positive group (51.7% vs. 22.2%, P = 0.0008), indicating a more aggressive CKD trajectory following SARS-CoV-2 infection. Using threshold of ≤ −4 ml/min/1.73 m²/year, COVID-19 infection independently conferred 3.7-fold higher odds of rapid GFR progression. Regression analysis identified COVID-19 infection and baseline eGFR as independent predictors of rapid decline
Conclusion: SARS-CoV-2 infection, regardless of COVID severity, significantly worsens long-term kidney outcomes in CKD patients. These findings emphasize the importance of early preventive strategies, vaccination coverage, and closer follow-up in this vulnerable population.

Keywords: Chronic kidney disease, COVID-19, Asymptomatic COVID, CKD progression, eGFR slope, Multicenter study

Citation:

Dr.Visnja Ležaić, Long-Term Impact Of SARS-CoV-2 Infection On The Progression Of Chronic Kidney Disease: Retrospective Study Of A National Multicenter Cohort. The Journal of Clinical Medicine 2026.