Ruby Vishnu Patel

All Publications

• Kidney Function Following COVID-19 in Children and Adolescents. JAMA network open Li, L., Zhou, T., Lu, Y., Chen, J., Lei, Y., Wu, Q., Arnold, J., Becich, M. J., Bisyuk, Y., Blecker, S., Chrischilles, E., Christakis, D. A., Geary, C. R., Jhaveri, R., Lenert, L., Liu, M., Mirhaji, P., Morizono, H., Mosa, A. S., Onder, A. M., Patel, R., Smoyer, W. E., Taylor, B. W., Williams, D. A., Dixon, B. P., Flynn, J. T., Gluck, C., Harshman, L. A., Mitsnefes, M. M., Modi, Z. J., Pan, C. G., Patel, H. P., Verghese, P. S., Forrest, C. B., Denburg, M. R., Chen, Y. 2025; 8 (4): e254129

  Abstract

  It remains unclear whether children and adolescents with SARS-CoV-2 infection are at heightened risk for long-term kidney complications.To investigate whether SARS-CoV-2 infection is associated with an increased risk of postacute kidney outcomes among pediatric patients, including those with preexisting kidney disease or acute kidney injury (AKI).This retrospective cohort study used data from 19 health institutions in the National Institutes of Health Researching COVID to Enhance Recovery (RECOVER) initiative from March 1, 2020, to May 1, 2023 (follow-up ≤2 years completed December 1, 2024; index date cutoff, December 1, 2022). Participants included children and adolescents (aged <21 years) with at least 1 baseline visit (24 months to 7 days before the index date) and at least 1 follow-up visit (28 to 179 days after the index date).SARS-CoV-2 infection, determined by positive laboratory test results (polymerase chain reaction, antigen, or serologic) or relevant clinical diagnoses. A comparison group included children with documented negative test results and no history of SARS-CoV-2 infection.Outcomes included new-onset chronic kidney disease (CKD) stage 2 or higher or CKD stage 3 or higher among those without preexisting CKD; composite kidney events (≥50% decline in estimated glomerular filtration rate [eGFR], eGFR ≤15 mL/min/1.73 m2, dialysis, transplant, or end-stage kidney disease diagnosis), and at least 30%, 40%, or 50% eGFR decline among those with preexisting CKD or acute-phase AKI. Hazard ratios (HRs) were estimated using Cox proportional hazards regression models with propensity score stratification.Among 1 900 146 pediatric patients (487 378 with and 1 412 768 without COVID-19), 969 937 (51.0%) were male, the mean (SD) age was 8.2 (6.2) years, and a range of comorbidities was represented. SARS-CoV-2 infection was associated with higher risk of new-onset CKD stage 2 or higher (HR, 1.17; 95% CI, 1.12-1.22) and CKD stage 3 or higher (HR, 1.35; 95% CI, 1.13-1.62). In those with preexisting CKD, COVID-19 was associated with an increased risk of composite kidney events (HR, 1.15; 95% CI, 1.04-1.27) at 28 to 179 days. Children with acute-phase AKI had elevated HRs (1.29; 95% CI, 1.21-1.38) at 90 to 179 days for composite outcomes.In this large US cohort study of children and adolescents, SARS-CoV-2 infection was associated with a higher risk of adverse postacute kidney outcomes, particularly among those with preexisting CKD or AKI, suggesting the need for vigilant long-term monitoring.

  View details for DOI 10.1001/jamanetworkopen.2025.4129

  View details for PubMedID 40214993

  View details for PubMedCentralID PMC11992607

• Post-acute and Chronic Kidney Function Outcomes of COVID-19 in Children and Adolescents: An EHR Cohort Study from the RECOVER Initiative. medRxiv : the preprint server for health sciences Li, L., Zhou, T., Lu, Y., Chen, J., Lei, Y., Wu, Q., Arnold, J., Becich, M. J., Bisyuk, Y., Blecker, S., Chrischilles, E., Christakis, D. A., Geary, C. R., Jhaveri, R., Lenert, L., Liu, M., Mirhaji, P., Morizono, H., Mosa, A. S., Onder, A. M., Patel, R., Smoyer, W. E., Taylor, B. W., Williams, D. A., Dixon, B. P., Flynn, J. T., Gluck, C., Harshman, L. A., Mitsnefes, M. M., Modi, Z. J., Pan, C. G., Patel, H. P., Verghese, P. S., Forrest, C. B., Denburg, M. R., Chen, Y. 2024

  Abstract

  We investigated the risks of post-acute and chronic adverse kidney outcomes of SARS-CoV-2 infection in the pediatric population via a retrospective cohort study using data from the RECOVER program. We included 1,864,637 children and adolescents under 21 from 19 children's hospitals and health institutions in the US with at least six months of follow-up time between March 2020 and May 2023. We divided the patients into three strata: patients with pre-existing chronic kidney disease (CKD), patients with acute kidney injury (AKI) during the acute phase (within 28 days) of SARS-CoV-2 infection, and patients without pre-existing CKD or AKI. We defined a set of adverse kidney outcomes for each stratum and examined the outcomes within the post-acute and chronic phases after SARS-CoV-2 infection. In each stratum, compared with the non-infected group, patients with COVID-19 had a higher risk of adverse kidney outcomes. For patients without pre-existing CKD, there were increased risks of CKD stage 2+ (HR 1.20; 95% CI: 1.13-1.28) and CKD stage 3+ (HR 1.35; 95% CI: 1.15-1.59) during the post-acute phase (28 days to 365 days) after SARS-CoV-2 infection. Within the post-acute phase of SARS-CoV-2 infection, children and adolescents with pre-existing CKD and those who experienced AKI were at increased risk of progression to a composite outcome defined by at least 50% decline in estimated glomerular filtration rate (eGFR), eGFR <15 mL/min/1.73m2, End Stage Kidney Disease diagnosis, dialysis, or transplant.

  View details for DOI 10.1101/2024.06.25.24309488

  View details for PubMedID 38978683

• Illness-related parental stress and quality of life in children with kidney diseases. Pediatric nephrology (Berlin, Germany) Patel, R., Wong, C. 2023

  View details for DOI 10.1007/s00467-023-06041-6

  View details for PubMedID 37330454