Department of Nephrology, Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands.
Transplantation. 2022 May 1;106(5):1012-1023. doi: 10.1097/TP.0000000000004075. Epub 2022 Apr 26.
Kidney transplant patients are at high risk for coronavirus disease 2019 (COVID-19)-related mortality. However, limited data are available on longer-term clinical, functional, and mental health outcomes in patients who survive COVID-19.
We analyzed data from adult kidney transplant patients in the European Renal Association COVID-19 Database who presented with COVID-19 between February 1, 2020, and January 31, 2021.
We included 912 patients with a mean age of 56.7 (±13.7) y. 26.4% were not hospitalized, 57.5% were hospitalized without need for intensive care unit (ICU) admission, and 16.1% were hospitalized and admitted to the ICU. At 3 mo follow-up survival was 82.3% overall, and 98.8%, 84.2%, and 49.0%, respectively, in each group. At 3 mo follow-up biopsy-proven acute rejection, need for renal replacement therapy, and graft failure occurred in the overall group in 0.8%, 2.6%, and 1.8% respectively, and in 2.1%, 10.6%, and 10.6% of ICU-admitted patients, respectively. Of the surviving patients, 83.3% and 94.4% reached their pre-COVID-19 physician-reported functional and mental health status, respectively, within 3 mo. Of patients who had not yet reached their prior functional and mental health status, their treating physicians expected that 79.6% and 80.0%, respectively, still would do so within the coming year. ICU admission was independently associated with a low likelihood to reach prior functional and mental health status.
In kidney transplant recipients alive at 3-mo follow-up, clinical, physician-reported functional, and mental health recovery was good for both nonhospitalized and hospitalized patients. Recovery was, however, less favorable for patients who had been admitted to the ICU.
肾移植患者感染 2019 冠状病毒病（COVID-19）相关死亡的风险很高。然而，关于 COVID-19 存活患者的长期临床、功能和心理健康结局的数据有限。
我们分析了 2020 年 2 月 1 日至 2021 年 1 月 31 日期间在欧洲肾脏协会 COVID-19 数据库中出现 COVID-19 的成年肾移植患者的数据。
我们纳入了 912 例平均年龄为 56.7（±13.7）岁的患者。26.4%的患者未住院，57.5%的患者住院但无需入住重症监护病房（ICU），16.1%的患者住院并入住 ICU。总的 3 个月随访生存率为 82.3%，在各组分别为 98.8%、84.2%和 49.0%。在 3 个月随访时，整个组中活检证实的急性排斥反应、需要肾脏替代治疗和移植物失败的发生率分别为 0.8%、2.6%和 1.8%，在 ICU 收治的患者中分别为 2.1%、10.6%和 10.6%。在存活的患者中，83.3%和 94.4%分别在 3 个月内达到其 COVID-19 前医生报告的功能和心理健康状态。在尚未达到其先前功能和心理健康状态的患者中，他们的治疗医生预计在未来一年内，分别有 79.6%和 80.0%仍将达到该状态。入住 ICU 与不太可能达到先前的功能和心理健康状态独立相关。
在 3 个月随访时存活的肾移植受者中，非住院和住院患者的临床、医生报告的功能和心理健康恢复情况良好。然而，对于入住 ICU 的患者，恢复情况较差。
