#2867 Is there an interrelationship between the SARS-CoV-2 virus and the BK polyomavirus in kidney transplant recipients?

Abstract

Abstract Background and Aims Several viral co-infections following SARS-CoV-2 infection have been described. However, there is very limited and inconclusive data on the relationship between COVID-19 and BK polyomavirus (BKV) in kidney transplant (KT) recipients. Method Retrospective analysis of KT recipients with BK infection (BKi) in our centre from March 2020 (first cases of COVID-19) to March 2023. BK viremia is periodically determined prospectively in all KTs performed in our hospital. We carried out a case-control study, choosing two controls without BKi for each case (closest transplant date and similar donor and recipient age). We analyzed clinical characteristics and evolution, as well as previous history of COVID-19 in both groups. A composite outcome including de novo BKi and/or significant increase in BK viremia (increase > 50% in at least 2 consecutive samples) was analyzed. Multivariate analysis was performed using logistic regression for de novo BKi and/or significant increase in BK viremia risk factors. Results During this period 235 KTs were performed in our center, of which 37 were diagnosed with BKi (16.1%). The median time from the date of KT to BKi was 73 days. When comparing cases versus controls, demographic characteristics and donor type were similar in both groups, except for a higher proportion of males in the BKi group (76.3% vs. 55.3%; p = 0.029). The incidence of SARS-CoV-2 infection was significantly higher in patients with de novo/increased viremia BKi than in the control group (44.7% vs. 26.3% p = 0.048). During follow-up, one patient in the BKi group died and one patient in the control group lost the graft due to causes other than viral infections. In multivariate analysis, male gender and SARS-CoV-2 infection were risk factors for the composite outcome. Conclusion As has been described with other viruses, there may be an interrelationship between SARS-CoV-2 and BKV. Our experience suggests that close monitoring for BKV after episodes of COVID-19 may be appropriate.