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Clinical characteristics and outcomes of hospitalized kidney transplant recipients with COVID-19 infection in China during the Omicron wave: a single-center cohort study.
Clinical characteristics and outcomes of hospitalized kidney transplant recipients with COVID-19 infection in China during the Omicron wave: a single-center cohort study.
- Source :
-
Journal of Zhejiang University. Science. B [J Zhejiang Univ Sci B] 2024 Jun 15; Vol. 25 (6), pp. 529-540. - Publication Year :
- 2024
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Abstract
- BACKGROUND : Following the short-term outbreak of coronavirus disease 2019 (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 Dec. 16, 2022 and Jan. 31, 2023. The patients were followed up until Mar. 31, 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 d. 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. The acute kidney injury (AKI) occurred in 81 (25.0%) 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-d 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, interleukin (IL)-6 level of >6.8 pg/mL, daily dose of corticosteroids of >50 mg, and fungal infection were all associated with an increased risk of death for hospitalized patients. CONCLUSIONS : 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.
- Subjects :
- Humans
Middle Aged
Male
Female
Retrospective Studies
China epidemiology
Adult
Hospitalization
Transplant Recipients
Aged
COVID-19 Drug Treatment
Antibodies, Monoclonal, Humanized therapeutic use
Azetidines
Purines
Pyrazoles
Sulfonamides
Kidney Transplantation
COVID-19 mortality
COVID-19 complications
COVID-19 epidemiology
Antiviral Agents therapeutic use
SARS-CoV-2
Subjects
Details
- Language :
- English; Chinese
- ISSN :
- 1862-1783
- Volume :
- 25
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of Zhejiang University. Science. B
- Publication Type :
- Academic Journal
- Accession number :
- 38910497
- Full Text :
- https://doi.org/10.1631/jzus.B2300538