Omicron Variant of SARS-CoV-2 Pandemic in Chinese Kidney Transplantation Population: A Nine-month Follow-up in Repeated Infection and Changes in Kidney Function

Abstract

China experienced one of the largest spikes in COVID-19 several months ago, followed by multiple rounds of reinfections. COVID-19 predisposes to the development of acute kidney injury (AKI) which has a higher developing risk in organ transplant recipients. However, few studies reported multiple infections and changes in renal function in the kidney transplant population in China. We followed up the patients who underwent kidney transplantation who completed our questionnaire at the initial spike of the epidemic and analyzed their infections and changes in renal function and analyzed the factors affecting the changes in renal function. A total of 148 patients were included and the follow-up time was 9 months. One hundred forty (94.6%) of our patients were infected with SARS-CoV-2 with clear evidence. Hospitalization rates were highest in the fifth month at 25.0%, and in the first month was at 15.0%. No patients were found to have been transferred to the intensive care unit or died during the follow-up period. Before the COVID-19 epidemic, the glomerular filtration rate (GFR) was 92.71 ± 28.80 (95% confidence interval [CI] = 88.02-97.41) mL/min /1.73 m2, and at the follow-up time it was 90.81 ± 28.12 (95% CI = 86.23-95.40) mL/min /1.73 m2 (P = 0.050). Fifty-seven (38.8%) patients had a rise in their GFR, and 4 (2.7%) patients increased over 30%. No patient resumed dialysis during the follow-up period. No factors significantly affected the GFR of the patients. Kidney transplant recipients were more symptomatic only with the first SARS-CoV-2 infection and less symptomatic with subsequent repeat infections. SARS-CoV-2 has little effect on renal function in the kidney transplantation population.