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Journal of Zhejiang University SCIENCE B 1998 Vol.-1 No.-1 P.

http://doi.org/10.1631/jzus.B2300538


Clinical characteristics and outcomes of hospitalized kidney transplant recipients with COVID-19 infection in China during the Omicron wave: A single-center cohort study


Author(s):  Duo LV, Xishao XIE, Qinyun YANG, Zhimin CHEN, Guangjun LIU, Wenhan PENG, Rending WANG, Hongfeng HUANG, Jianghua CHEN, Jianyong WU

Affiliation(s):  Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; more

Corresponding email(s):   wujianyong1964@zju.edu.cn

Key Words:  COVID-19, kidney transplant, China, mortality


Duo LV, Xishao XIE, Qinyun YANG, Zhimin CHEN, Guangjun LIU, Wenhan PENG, Rending WANG, Hongfeng HUANG, Jianghua CHEN,Jianyong WU. Clinical characteristics and outcomes of hospitalized kidney transplant recipients with COVID-19 infection in China during the Omicron wave: A single-center cohort study[J]. Journal of Zhejiang University Science B, 1998, -1(-1): .

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%T Clinical characteristics and outcomes of hospitalized kidney transplant recipients with COVID-19 infection in China during the Omicron wave: A single-center cohort study
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%A Xishao XIE
%A Qinyun YANG
%A Zhimin CHEN
%A Guangjun LIU
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%A Rending WANG
%A Hongfeng HUANG
%A Jianghua CHEN
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A1 - Duo LV
A1 - Xishao XIE
A1 - Qinyun YANG
A1 - Zhimin CHEN
A1 - Guangjun LIU
A1 - Wenhan PENG
A1 - Rending WANG
A1 - Hongfeng HUANG
A1 - Jianghua CHEN
A1 - Jianyong WU
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DOI - 10.1631/jzus.B2300538


Abstract: 
Following the short-term outbreak of COVID-19 in December 2022 in china, clinical data on kidney transplant recipients (KTRs) with COVID-19 are lacking. Methods We conducted a single-center retrospective study to describe the clinical features, complications and mortality rates of hospitalized KTRs infected with COVID-19 between 16 December 2022 and 31 January 2023. The patients were followed up until 31 March 2023. Results A total of 324 KTRs with COVID-19 were included. The median age was 49 years. The median time between the onset of symptoms and admission was 13 days. Molnupiravir, azvudine and nirmatrelvir/ritonavir were administered to 67 (20.7%), 11 (3.4%) and 148 (45.7%) patients, respectively. Twenty-nine (9.0%) patients were treated with more than one antiviral agent. Forty-eight (14.8%) patients were treated with tocilizumab and 53 (16.4%) patients received baricitinib therapy. AKI occurred in 81 (25%) patients and 39 (12.0%) patients were admitted to intensive care units. Fungal infections were observed in 55 (17.0%) patients. Fifty (15.4%) patients lost their graft. The 28-day mortality rate of patients was 9.0% and 42 (13.0%) patients died by the end of follow-up. Multivariate Cox regression analysis identified that cerebrovascular disease, AKI incidence, IL-6 levels > 6.8 pg/mL, daily dose of corticosteroids > 50 mg, and fungal infection were all associated with an increased risk of death for hospitalized patients. Conclusion Our findings demonstrate that hospitalized KTRs with COVID-19 are at high risk of mortality. The administration of immunomodulators or the late application of antiviral drugs does not improve patient survival, while higher doses of corticosteroids may increase the death risk.

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