Risk factors for mortality in kidney transplant recipients with COVID‐19: a single centre experience and case–control study

Abstract

Background COVID-19 infection is considered to cause high mortality in kidney transplant recipients (KTR). Old age, comorbidities and acute kidney injury are known risk factors for increased mortality in KTR. Nevertheless, mortality rates have varied across different regions. Differences in age, comorbidities and varying standards of care across geographies may explain some variations. However, it is still unclear whether post-transplant duration, induction therapy, antirejection therapy and co-infections contribute to increased mortality in KTR with COVID-19. The present study assessed risk factors in a large cohort from India. Methods A matched case–control study was performed to analyze risk factors for death in KTR (N = 218) diagnosed with COVID-19 between April 2020 to July 2021 at the study centre. Cases were KTR who died (non-survivors, N = 30), whereas those who survived were taken as controls (survivors, N = 188). Results A high death-to-case ratio of 13.8% was observed amongst study group KTR infected with COVID-19. There was a high incidence (12.4%) of co-infections, with cytomegalovirus being the most common co-infection among non-survivors. Diarrhea, co-infection, high oxygen requirement, and need for mechanical ventilation were significantly associated with mortality on regression analyses. Antirejection therapy, lymphopenia and requirement for renal replacement therapy were associated with worse outcomes. Conclusions The mortality was much higher in KTR who required mechanical ventilation and had co-infections. Mortality did not vary with the type of transplant, post-transplant duration and usage of depletion induction therapy. An aggressive approach has to be taken for an early diagnosis and therapeutic intervention of associated infections.

Risk factors for SARS-CoV-2 pneumonia among renal transplant recipients in Beijing Omicron wave

“…From the results of the European Renal Association COVID-19 Database (ERACODA) database, most of the enrolled 305 RTRs with COVID-19 were males with a mean age of 60 ± 13 years ( 18 ). The single center also showed that COVID-19 infection in this RTR group affected men more than women ( 19 ). In our study, the two groups in the gender category had statistically comparative differences, and there was a preponderance of males in both groups.…”

Manifestaciones clínicas y factores asociados a mortalidad por COVID-19 en receptores de trasplante renal en un centro colombiano

“…Llama la atención la proporción de pacientes que inició con diarrea como síntoma principal del cuadro clínico (34%), este fenómeno ya se había descrito en la literatura y se había postulado como factor con potencial riesgo para mortalidad 18 ; sin embargo en nuestra experiencia no fue posible establecer algún tipo de asociación con significancia estadística o clínica.…”

Risk factors and multi-pathogen infections in kidney transplant recipients with omicron variant pneumonia: a retrospective analysis

“…KTRs have a poorer prognosis than the general population with regard to COVID-19 infections. Early data revealed that the mortality rate of KTRs infected with COVID-19 ranges from 20 to 32% [1,[3][4][5], according to data from WHO, the infection fatality ratio for COVID-19 in the general population is estimated to converge at approximately 0.5 to 1% [6].…”

“…(4) The SARS-CoV-2 strain is identified as Omicron variant by Sanger sequence or BALF-mNGS. (5) Ethnicity: Asian Chinese Han population.…”