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Background <p>Obesity and SARS-CoV-2 infection have both been associated with renal injury through inflammatory, endothelial, and microvascular mechanisms. Whether a history of COVID-19 modifies renal trajectories after metabolic surgery remains unclear.</p> Objective <p>To evaluate the association between prior COVID-19 infection and renal outcomes 12 months after laparoscopic Roux-en-Y gastric bypass (LRYGB).</p> Methods <p>We conducted a prospective cohort study including 38 adults with severe obesity (BMI ≥ 35 kg/m² with comorbidities or ≥ 40 kg/m²) and preserved baseline kidney function who underwent LRYGB between January 2022 and January 2024. Participants were stratified according to a history of laboratory-confirmed COVID-19 infection. Renal outcomes included measured and estimated glomerular filtration rate, creatinine and urea clearance, 24-h proteinuria, albuminuria, and urine albumin-to-creatinine ratio (ACR). KDIGO combined G/A risk categories were assessed at baseline and 12 months. Longitudinal changes were explored using within-group analyses and between-group comparisons of trajectories.</p> Results <p>Eighteen patients (47%) had a history of COVID-19 infection. Weight loss and metabolic response were comparable between groups (BMI 44 ± 6 to 29 ± 5 kg/m²; p &lt; 0.01). Classical renal function parameters remained stable in both groups. ACR decreased significantly over time only among patients without prior COVID-19 infection (14 ± 14 to 7 ± 6 mg/g; p = 0.03), whereas the reduction did not reach statistical significance in previously infected patients (12 ± 10 to 10 ± 10 mg/g; p = 0.20). However, formal between-group analyses did not demonstrate a statistically significant difference in renal trajectories.</p> Conclusions <p>LRYGB was associated with substantial weight loss and stable renal function at 12 months regardless of prior COVID-19 infection. A differential within-group pattern in albuminuria improvement was observed, but between-group differences were not statistically significant. These findings should be interpreted as exploratory and hypothesis-generating, highlighting the need for larger studies with longer follow-up and mechanistic biomarkers to clarify renal outcomes after metabolic surgery in patients with a history of COVID-19 infection.</p>

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Impact of Prior COVID-19 Infection on Renal Outcomes after Roux-en-Y Gastric Bypass: A 12-Month Prospective Study

  • 期刊论文

  • 发表日期：

    2026年2月12日

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  • Manuel Garcia,
  • Ricardo Mishima,
  • Melina Bertelo-Grecco,
  • Maria del Valle Rodriguez,
  • Nadia Berdeja,
  • Fernando Martinez Lascano,
  • Carlos Martin Esquivel

摘要

Background

Obesity and SARS-CoV-2 infection have both been associated with renal injury through inflammatory, endothelial, and microvascular mechanisms. Whether a history of COVID-19 modifies renal trajectories after metabolic surgery remains unclear.

Objective

To evaluate the association between prior COVID-19 infection and renal outcomes 12 months after laparoscopic Roux-en-Y gastric bypass (LRYGB).

Methods

We conducted a prospective cohort study including 38 adults with severe obesity (BMI ≥ 35 kg/m² with comorbidities or ≥ 40 kg/m²) and preserved baseline kidney function who underwent LRYGB between January 2022 and January 2024. Participants were stratified according to a history of laboratory-confirmed COVID-19 infection. Renal outcomes included measured and estimated glomerular filtration rate, creatinine and urea clearance, 24-h proteinuria, albuminuria, and urine albumin-to-creatinine ratio (ACR). KDIGO combined G/A risk categories were assessed at baseline and 12 months. Longitudinal changes were explored using within-group analyses and between-group comparisons of trajectories.

Results

Eighteen patients (47%) had a history of COVID-19 infection. Weight loss and metabolic response were comparable between groups (BMI 44 ± 6 to 29 ± 5 kg/m²; p < 0.01). Classical renal function parameters remained stable in both groups. ACR decreased significantly over time only among patients without prior COVID-19 infection (14 ± 14 to 7 ± 6 mg/g; p = 0.03), whereas the reduction did not reach statistical significance in previously infected patients (12 ± 10 to 10 ± 10 mg/g; p = 0.20). However, formal between-group analyses did not demonstrate a statistically significant difference in renal trajectories.

Conclusions

LRYGB was associated with substantial weight loss and stable renal function at 12 months regardless of prior COVID-19 infection. A differential within-group pattern in albuminuria improvement was observed, but between-group differences were not statistically significant. These findings should be interpreted as exploratory and hypothesis-generating, highlighting the need for larger studies with longer follow-up and mechanistic biomarkers to clarify renal outcomes after metabolic surgery in patients with a history of COVID-19 infection.