Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.
Transplant Proc. 2022 May;54(4):884-887. doi: 10.1016/j.transproceed.2022.03.003. Epub 2022 Mar 16.
Kidney transplant recipients (KTRs) are at an increased risk of infection with severe acute respiratory syndrome coronavirus 2, with mortality from 13% to over 30%. However, data concerning the influence of COVID-19 on long-term graft function in convalescents is lacking. The aim of this study was to evaluate the influence of COVID-19 on graft function at 6 months after recovery.
A longitudinal controlled study was conducted in a group of 1058 KTRs. Of 180 patients with COVID-19 in the past, 77 KTRs (45 male) with a mean age 50.57 ± 13.37 years, Charlson Comorbidity Index of 3 (median; interquartile range [IQR], 3-5), Fragility Score of 3 (median; IQR, 3-3), and minimum 6 months after acute COVID-19 were included. The most common symptoms were weakness (75.33%), fever (74.03%), cough (51.95%), and loss of appetite (48.05%). Thirty-three patients were hospitalized; none required invasive ventilation therapy, but 16 required oxygen support. The treatment of COVID-19 included antibiotics (38.96%), thromboprophylaxis (25.97%), and nonsteroidal anti-inflammatory drugs, or paracetamol (25.97%).
The median (IQR) values of serum creatinine 3 months before the onset and 6 months after COVID-19 were 1.25 (0.98-1.86) and 1.26 (1.03-1.78) mg/dL (nonsignificant difference); in strata analysis, there were also no differences with regards to patients with higher and lower comorbidity (3 < Charlson Comorbidity Index < 3) and fragility (3 < Fragility Score < 3). Furthermore, creatinine concentration in KTRs and controls did not differ.
In the group of KTRs with a mild course of COVID-19, no negative impact of the infection on graft function was observed 6 months after transplantation.
肾移植受者(KTR)感染严重急性呼吸综合征冠状病毒 2 的风险增加,死亡率为 13%至 30%以上。然而,关于 COVID-19 对康复后长期移植物功能的影响的数据尚缺乏。本研究旨在评估 COVID-19 对康复后 6 个月移植物功能的影响。
对一组 1058 名 KTR 进行了一项纵向对照研究。在过去的 180 例 COVID-19 患者中,纳入了 77 名 KTR(45 名男性),平均年龄 50.57±13.37 岁,Charlson 合并症指数为 3(中位数;四分位距[IQR],3-5),脆弱指数为 3(中位数;IQR,3-3),且在急性 COVID-19 后至少 6 个月。最常见的症状是乏力(75.33%)、发热(74.03%)、咳嗽(51.95%)和食欲不振(48.05%)。33 名患者住院,无患者需要有创通气治疗,但 16 名患者需要氧疗支持。COVID-19 的治疗包括抗生素(38.96%)、血栓预防(25.97%)和非甾体抗炎药或对乙酰氨基酚(25.97%)。
发病前 3 个月和 COVID-19 后 6 个月血清肌酐的中位数(IQR)值分别为 1.25(0.98-1.86)和 1.26(1.03-1.78)mg/dL(无显著差异);在分层分析中,对于合并症较高和较低(3<Charlson 合并症指数<3)和脆弱性较高和较低(3<脆弱性评分<3)的患者,也没有差异。此外,KTR 和对照组的肌酐浓度没有差异。
在 COVID-19 轻度发作的 KTR 组中,感染对移植物功能没有负面影响,在移植后 6 个月观察到。