Volume 14 Issue 5
Sep.  2023
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Wei Fen, Li Ning, Wang Mingjun, et al. Epidemiological characteristics of SARS-CoV-2 pneumonia in kidney transplant recipients : a single-center retrospective study[J]. ORGAN TRANSPLANTATION, 2023, 14(5): 700-707. doi: 10.3969/j.issn.1674-7445.2023098
Citation: Wei Fen, Li Ning, Wang Mingjun, et al. Epidemiological characteristics of SARS-CoV-2 pneumonia in kidney transplant recipients : a single-center retrospective study[J]. ORGAN TRANSPLANTATION, 2023, 14(5): 700-707. doi: 10.3969/j.issn.1674-7445.2023098
shu

Epidemiological characteristics of SARS-CoV-2 pneumonia in kidney transplant recipients : a single-center retrospective study

doi: 10.3969/j.issn.1674-7445.2023098

  • Department of Kidney Transplantation, the Second People's Hospital of Shanxi Province, Taiyuan 030012, China

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  • Corresponding author: Li Ning, Email: SXTYLining666@126.com
  • Received Date: 2023-05-06
  • Accepted Date: 2023-07-14
    • Available Online: 2023-07-20
  • Publish Date: 2023-09-15
    Abstract
  •   Objective  To investigate the epidemiological characteristics of SARS-CoV-2 pneumonia in kidney transplant recipients and analyze the risk and protective factors of severe/critical infection with SARS-CoV-2.   Methods  Clinical data of 468 kidney transplant recipients infected with SARS-CoV-2 were retrospectively analyzed. According to the severity of infection, they were divided into mild SARS-CoV-2 infection recipients (n=439) and SARS-CoV-2 pneumonia group (n=29). Among the 439 mild SARS-CoV-2 infection recipients, 87 recipients who were randomly matched with their counterparts in the SARS-CoV-2 pneumonia group according to sex, age and transplantation time at a ratio of 3∶1 were allocated into the mild SARS-CoV-2 infection group. Twenty-nine recipients in the SARS-CoV-2 pneumonia group were divided into the moderate SARS-CoV-2 pneumonia group (n=21) and severe/critical SARS-CoV-2 pneumonia group (n=8). Baseline data of all recipients were collected. The risk and protective factors of SARS-CoV-2 infection in kidney transplant recipients were identified.   Results  The proportion of recipients complicated with 2-3 types of complications in the SARS-CoV-2 pneumonia group was higher than that in the mild SARS-CoV-2 infection group, and the proportion of recipients treated with tacrolimus(Tac)+mizoribine+glucocorticoid immunosuppression regimen in the SARS-CoV-2 pneumonia group was lower than that in the mild SARS-CoV-2 infection group, and significant differences were observed (both P<0.05). In 29 kidney transplant recipients with SARS-CoV-2 pneumonia in the SARS-CoV-2 pneumonia group, white blood cells, the absolute values of lymphocytes, eosinophils, total T cells, CD4+T cells and CD8+T cells, and serum uric acid levels were significantly lower, whereas ferritin levels were significantly higher than the values prior to SARS-CoV-2 pneumonia, and significant differences were observed (all P<0.05). Compared with the moderate SARS-CoV-2 pneumonia group, the proportion of recipients with hypoxemia was higher, the proportion of recipients treated with Tac/ciclosporin (CsA)+mycophenolate mofetil+glucocorticoid immunosuppression regimen was higher, and the proportion of recipients administered with 2-3 doses of SARS-CoV-2 vaccine was lower in the severe/critical SARS-CoV-2 pneumonia group, and significant differences were observed (all P<0.05).   Conclusions  More complications and immunosuppression regimen containing mycophenolate mofetil are the risk factor for SARS-CoV-2 infection in kidney transplant recipients. Vaccination with SARS-CoV-2 vaccine and immunosuppression regimen containing mizoribine are probably the protective factors for lowering the risk of SARS-CoV-2 infection. The levels of inflammatory cytokines are associated with the severity of SARS-CoV-2 pneumonia.

     

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