Abstract
BackgroundAlthough most evidence supports the fact that kidney transplant (KT) recipients are at significant risk of morbidity and mortality, risk factors of accruing COVID-19 in this population have remained poorly defined.MethodsAll KT recipients who had been transplanted in Sina Hospital and were actively followed between March 1996 and January 2021 were enrolled in a retrospective manner. The demographic characteristics, immunosuppressive treatment before KT, and death were gathered by calling patients with a designed questionnaire.Results108 (about 21%) of 523 KT recipients were diagnosed with COVID-19. The mean age of COVID-19 patients was 46.9 ± 13.6, of whom 43% were women. In the multivariate model, body mass index (BMI) ≥ 30 independently increased the risk of COVID-19 incidence with OR 2.00 (95% CI 1.23, 3.26) (P = 0.00), and besides, having diabetes had a marginal association with COVID-19 incidence (OR 1.62 [95% CI 0.98, 2.66]; P = 0.057). The mortality rate of COVID-19 was 15%. In the multivariate model, only pre-transplantation diabetes significantly increased the risk of death by COVID-19 with OR of 3.90 (95% CI 1.00–15.16) (P = 0.04).ConclusionGiven the higher incidence rate in KT recipients with obesity and diabetes and higher mortality rate in KT recipients with diabetes as the cause of ESRD, more attention should be paid to KT recipients with these risk factors.
Highlights
2.2 Study DesignCurrently, the entire world is tackling the novel coronavirus (SARS-CoV-2) that has caused coronavirus disease 2019 (COVID-19) [1, 2]
The prevalence of diabetes, hypertension, renal stone, and polycystic kidney disease as primary causes of end-stage renal disease (ESRD) in COVID-19 patients was 13%, 37%, 3%, and 9.3%, respectively; none of them showed a significant association with COVID-19 disease
The present study found that diabetes, obesity, and shorter pre-transplant dialysis period independently increased the risk of COVID-19 among kidney transplant (KT) recipients
Summary
2.2 Study DesignCurrently, the entire world is tackling the novel coronavirus (SARS-CoV-2) that has caused coronavirus disease 2019 (COVID-19) [1, 2]. A bulk of evidence claims that the whole mortality rate of this virus ranges from 3.7 to 11%, several groups are at higher risk of death from the virus, those with chronic underlying disease [5, 6]. Kidney transplant (KT) recipients are at higher risk of viral and bacterial infections than the general population, which primarily results from poor T-cell immunity of KT recipients [7, 8]. Most evidence supports the fact that kidney transplant (KT) recipients are at significant risk of morbidity and mortality, risk factors of accruing COVID-19 in this population have remained poorly defined. Only pre-transplantation diabetes significantly increased the risk of death by COVID-19 with OR of 3.90 (95% CI 1.00–15.16) (P = 0.04). Conclusion Given the higher incidence rate in KT recipients with obesity and diabetes and higher mortality rate in KT recipients with diabetes as the cause of ESRD, more attention should be paid to KT recipients with these risk factors
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