Department of Nephrology Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Epidemiol Glob Health. 2021 Dec;11(4):389-396. doi: 10.1007/s44197-021-00015-3. Epub 2021 Nov 26.
Although most evidence supports the fact that kidney transplant (KT) recipients are at significant risk of morbidity and mortality, risk factors of accruing COVID-19 in this population have remained poorly defined.
All KT recipients who had been transplanted in Sina Hospital and were actively followed between March 1996 and January 2021 were enrolled in a retrospective manner. The demographic characteristics, immunosuppressive treatment before KT, and death were gathered by calling patients with a designed questionnaire.
108 (about 21%) of 523 KT recipients were diagnosed with COVID-19. The mean age of COVID-19 patients was 46.9 ± 13.6, of whom 43% were women. In the multivariate model, body mass index (BMI) ≥ 30 independently increased the risk of COVID-19 incidence with OR 2.00 (95% CI 1.23, 3.26) (P = 0.00), and besides, having diabetes had a marginal association with COVID-19 incidence (OR 1.62 [95% CI 0.98, 2.66]; P = 0.057). The mortality rate of COVID-19 was 15%. In the multivariate model, only pre-transplantation diabetes significantly increased the risk of death by COVID-19 with OR of 3.90 (95% CI 1.00-15.16) (P = 0.04).
Given the higher incidence rate in KT recipients with obesity and diabetes and higher mortality rate in KT recipients with diabetes as the cause of ESRD, more attention should be paid to KT recipients with these risk factors.
尽管大多数证据都表明肾移植（KT）受者存在显著的发病率和死亡率风险，但该人群中 COVID-19 累积的风险因素仍未得到明确界定。
通过设计问卷与患者电话联系，回顾性纳入 1996 年 3 月至 2021 年 1 月期间在我院接受移植并积极随访的所有 KT 受者。收集患者的人口统计学特征、KT 前免疫抑制治疗和死亡情况。
523 例 KT 受者中，有 108 例（约 21%）被诊断为 COVID-19。COVID-19 患者的平均年龄为 46.9±13.6 岁，其中 43%为女性。在多变量模型中，BMI≥30 独立增加 COVID-19 发病风险，OR 为 2.00（95%CI 1.23，3.26）（P=0.00），此外，糖尿病与 COVID-19 发病有边缘关联（OR 1.62[95%CI 0.98，2.66]；P=0.057）。COVID-19 的死亡率为 15%。在多变量模型中，只有移植前糖尿病显著增加 COVID-19 死亡的风险，OR 为 3.90（95%CI 1.00-15.16）（P=0.04）。
鉴于肥胖和糖尿病的 KT 受者发病率较高，且糖尿病是 ESRD 的 KT 受者死亡率较高，因此应更加关注具有这些风险因素的 KT 受者。
