Predictor factor for worse outcomes in kidney transplant recipients infected with coronavirus disease 2019: A systematic review and meta-analysis

Duarsa, Gede Wirya Kusuma; Sugianto, Ronald; Yusari, I Gusti Agung Ayu Andra; Tirtayasa, Pande Made Wisnu; Situmorang, Gerhard Reinaldi; Rasyid, Nur; Rodjani, Arry; Daryanto, Besut; Seputra, Kurnia Penta; Satyagraha, Paksi

doi:10.1016/j.trim.2022.101739

Cited by 6 publications

(3 citation statements)

References 46 publications

(52 reference statements)

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“…For example, the incidence of pneumonia, the proportion of transfer to intensive care unit (ICU), and the mortality rate of the solid organ transplantation recipients recipients were increased compared with other COVID-19 infected patients [21] . Among hospitalized recipients of KTRs, the risk of secondary acute kidney injury and dyspnea is 3.78 times and 4.53 times higher than that of normal individuals, respectively, indicating poor prognosis [22] .…”

Section: Discussionmentioning

confidence: 99%

Comparative study of COVID-19 infection in renal transplant recipients and non transplant recipients

Pan,

lan,

Peng

et al. 2024

Preprint

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To analyse the difference in COVID-19 infection between kidney transplant patients and non-transplant patients. We included post-transplant patients with COVID-19 infection who attended Shenzhen No. 3 Hospital from December 2022 to February 2023, and enrolled the general population with COVID-19 infection who were hospitalized during the same period, matched by age and gender. They were divided into Kidney Transplant Recipients group (KTR) (n=194) and Non-Kidney Transplant Recipients Group（NKTR）(n=516) and the basic information, clinical symptoms, laboratory data, treatments and outcomes of these two groups were compared. The proportion of the renal transplant population classified as severe and critical was 15.5%, which was significantly higher than that in NKTR group (P < 0.05); the proportion of patients with pneumonia was also significantly higher than that in NKTR group. The mean maximum fever temperature was slightly higher in the NKTR(P<0.001);Kidney transplant population having lower absolute lymphocyte counts on admission and 7 days after admission than the general population, with statistically significant differences（P<0.001, P＜0.001). The use of intravenous hormones was significantly higher (42.8% vs. 6.0%, p=0.000), as was the use of small molecules such as Azvudine and Paxlovid, compared to the general population. A total of 10 patients in the included population required ICU admission, all in the KTR group; six patients experienced death, also in the renal transplant group. Conclusion: Post-transplant COVID-19 infections are more severe and require hormonal and small molecule antiviral therapy, and the prognosis is worse than in the general population. Trial registration This study was approved and supervised by the ethics committee of the Third People's Hospital of Shenzhen (approval number 2023-036-02) and firstly registered in 03/07/2023, registration number was NCT05926076.

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Section: Discussionmentioning

confidence: 99%

Comparative study of COVID-19 infection in renal transplant recipients and non transplant recipients

Pan,

lan,

Peng

et al. 2024

Preprint

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“…For example, in one study, the incidence of pneumonia, the proportion of transfers to the ICU, and the mortality rate of SOTRs were significantly higher than in non-SOT COVID-19-infected patients ( 49 ). Among hospitalized kidney transplant recipients, the risks of secondary acute kidney injury and dyspnea were 3.78- and 4.53-times higher than for normal individuals, respectively, and these features indicated a poor prognosis ( 50 ). Kulkarni et al ( 51 ) summarized 18 papers on COVID-19 infection in liver transplant recipients and found that the incidence of secondary acute renal injury after COVID-19 was 33.2%, the incidence of thrombosis was 5.8%, the incidence of bacterial infection was 11.6%, and the incidence of fungal infection was 2.6%.…”

Section: Clinical Characteristics and Prognosis Of Organ Transplant R...mentioning

confidence: 99%

A review of the clinical characteristics and management of immunosuppressed patients living with HIV or solid organ transplants infected with SARS-CoV-2 omicron variants

Song,

Lou,

Zhang

2024

Front. Public Health

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron strain was first detected in South Africa in November 2021. Although clinical responses to SARS-CoV-2 depend on host immunity, it remains uncertain how immunosuppression affects subsequent coronavirus disease 2019-related (COVID-19-related) incidence, severity, and mortality, especially with respect to the omicron strain. Conversely, immunosuppressants are often thought to predispose to infection. To explore the associations between host immunity and infection with SARS-CoV-2 omicron variants, here we discuss two groups of immunosuppressed patients: organ transplant recipients, who generally receive exogenous immunosuppressants, and Human Immunodeficiency Virus (HIV)-infected patients, who often have disease-related immunosuppression. In summarizing the clinical features and prognoses of HIV-infected patients and human organ transplant recipients infected with SARS-CoV-2 omicron variants, we provide new insights into the pathogenesis of omicron SARS-CoV-2 and provide a framework for the management of these patients now and in the future.

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“…This susceptibility is attributed to advanced age and higher frequency of comorbidities such as hypertension, diabetes, obesity, and cardiovascular diseases, all recognized as significant risk factors associated with worse COVID-19 prognosis. Furthermore, the chronic immunosuppressed state in these patients may exacerbate their susceptibility to severe outcomes associated with the virus (2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and outcomes in COVID-19 in kidney transplant recipients: a propensity score matched cohort study

Delfino-Pereira,

Ventura,

Pires

et al. 2024

Front. Med.

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Patients with chronic kidney disease (CKD), especially those on dialysis or who have received a kidney transplant (KT), are considered more vulnerable to severe COVID-19. This susceptibility is attributed to advanced age, a higher frequency of comorbidities, and the chronic immunosuppressed state, which may exacerbate their susceptibility to severe outcomes. Therefore, our study aimed to compare the clinical characteristics and outcomes of COVID-19 in KT patients with those on chronic dialysis and non-CKD patients in a propensity score-matched cohort study. This multicentric retrospective cohort included adult COVID-19 laboratory-confirmed patients admitted from March/2020 to July/2022, from 43 Brazilian hospitals. The primary outcome was in-hospital mortality. Propensity score analysis matched KT recipients with controls - patients on chronic dialysis and those without CKD (within 0.25 standard deviations of the logit of the propensity score) - according to age, sex, number of comorbidities, and admission year. This study included 555 patients: 163 KT, 146 on chronic dialysis, and 249 non-CKD patients (median age 57 years, 55.2% women). With regards to clinical outcomes, chronic dialysis patients had a higher prevalence of acute heart failure, compared to KT recipients, furthermore, both groups presented high in-hospital mortality, 34.0 and 28.1%, for KT and chronic dialysis patients, respectively. When comparing KT and non-CKD patients, the first group had a higher incidence of in-hospital dialysis (26.4% vs. 8.8%, p < 0.001), septic shock (24.1% vs. 12.0%, p = 0.002), and mortality (32.5% vs. 23.3%, p = 0.039), in addition to longer time spent in the intensive care unit (ICU). In this study, chronic dialysis patients presented a higher prevalence of acute heart failure, compared to KT recipients, whereas KT patients had a higher frequency of complications than those without CKD, including septic shock, dialysis during hospitalization, and in-hospital mortality as well as longer time spent in the ICU.

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Predictor factor for worse outcomes in kidney transplant recipients infected with coronavirus disease 2019: A systematic review and meta-analysis

Cited by 6 publications

References 46 publications

Comparative study of COVID-19 infection in renal transplant recipients and non transplant recipients

Comparative study of COVID-19 infection in renal transplant recipients and non transplant recipients

A review of the clinical characteristics and management of immunosuppressed patients living with HIV or solid organ transplants infected with SARS-CoV-2 omicron variants

Clinical characteristics and outcomes in COVID-19 in kidney transplant recipients: a propensity score matched cohort study

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