Epidemiologic and Translational Investigation of Long-Term Kidney Outcomes After COVID-19

PROJECT SUMMARY/ABSTRACT Candidate Steven Menez, MD, MHS, is an Instructor of Medicine in the Division of Nephrology at Johns Hopkins University School of Medicine, who will be promoted to Assistant Professor of Medicine on July 1, 2020. He seeks a K23 Mentored Patient-Oriented Research Career Development Award in order to develop and execute his proposed research project aimed at investigating the long-term kidney outcomes in hospitalized patients diagnosed with the novel Coronavirus Disease 2019 (COVID-19) surviving to discharge. This proposal additionally details a five-year plan consisting of advanced training in analytic methods and research study design, as well as mentorship by Chirag Parikh, MD, PhD, and Morgan Grams, MD, PhD. Dr. Menez's immediate career goals include the investigation of kidney injury and inflammation phenotypes in hospitalized patients with COVID-19 surviving to discharge and the evaluation of long-term kidney outcomes and mortality in COVID-19 hospitalization survivors. His long-term goal is to become an independent physician-scientist specializing in translational AKI research, with a specific focus on preventing the progression of CKD after AKI, in particular viral-associated AKI. Throughout this award process he will enrich his education and training through additional classes at the Johns Hopkins Bloomberg School of Public Health, in addition to working closely with his team of mentors and advisors. Dr. Menez's proposed work will help in his transition to an R01- funded independent investigator. Project Over 6 million people worldwide have been diagnosed with COVID-19.1,2 Acute kidney injury (AKI) is a frequent complication in hospitalizations for COVID-19, which has been associated with poor short-term outcomes, including in-hospital mortality.3,4 The goals of this proposal are to investigate the prevalence of elevated albuminuria and other biomarkers of kidney injury and inflammation at 3 months post-discharge in 250 patients with COVID-19 surviving hospitalization, and to associate these markers with kidney function decline and mortality at 24 months. This study will also quantify changes in kidney function over time in a larger cohort of all patients in the Johns Hopkins Health System admitted with COVID-19 (N~2000). The candidate hypothesizes that patients hospitalized with COVID-19 who develop clinical AKI and survive to discharge will have significantly greater albuminuria and higher levels of biomarkers of kidney injury and inflammation at 3 months post-discharge, and these phenotypes will associate with worse kidney outcomes and mortality up to 24 months. Further, he hypothesizes that patients with clinical AKI in the hospital will have worse kidney function decline and higher mortality at 24 months than patients without clinical AKI.