COVID-19 Outcomes in Kidney Transplant Recipients in a German Transplant Center

Autor: Michael Mikhailov, Klemens Budde, Fabian Halleck, Georgios Eleftheriadis, Marcel G. Naik, Eva Schrezenmeier, Friederike Bachmann, Mira Choi, Wiebke Duettmann, Ellen von Hoerschelmann, Nadine Koch, Lutz Liefeldt, Christian Lücht, Henriette Straub-Hohenbleicher, Johannes Waiser, Ulrike Weber, Bianca Zukunft, Bilgin Osmanodja
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of Clinical Medicine, Vol 12, Iss 18, p 6103 (2023)
Druh dokumentu: article
ISSN: 2077-0383
DOI: 10.3390/jcm12186103
Popis: Kidney transplant recipients (KTRs) show higher morbidity and mortality from COVID-19 than the general population and have an impaired response to vaccination. We analyzed COVID-19 incidence and clinical outcomes in a single-center cohort of approximately 2500 KTRs. Between 1 February 2020 and 1 July 2022, 578 KTRs were infected with SARS-CoV-2, with 25 (4%) recurrent infections. In total, 208 KTRs (36%) were hospitalized, and 39 (7%) died. Among vaccinated patients, infection with the Omicron variant had a mortality of 2%. Unvaccinated patients infected with the Omicron variant showed mortality (9% vs. 11%) and morbidity (hospitalization 52% vs. 54%, ICU admission 12% vs. 18%) comparable to the pre-Omicron era. Multivariable analysis revealed that being unvaccinated (OR = 2.15, 95% CI [1.38, 3.35]), infection in the pre-Omicron era (OR = 3.06, 95% CI [1.92, 4.87]), and higher patient age (OR = 1.04, 95% CI [1.03, 1.06]) are independent risk factors for COVID-19 hospitalization, whereas a steroid-free immunosuppressive regimen was found to reduce the risk of COVID-19 hospitalization (OR = 0.51, 95% CI [0.33, 0.79]). This suggests that both virological changes in the Omicron variant and vaccination reduce the risk for morbidity and mortality from COVID-19 in KTRs. Our data extend the knowledge from the general population to KTRs and provide important insights into outcomes during the Omicron era.
Databáze: Directory of Open Access Journals
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