COVID-19 exposure significantly affects graft function within 1 year (< 0.001).
Severe COVID-19 infections are associated with lower graft survival rates (< 0.001).
A lower estimated glomerular filtration rate () level is observed in patients with severe COVID-19 (< 0.001).
Tacrolimus use is linked to a lower likelihood of severe COVID-19 compared to cyclosporine (= 0.004).
Hyperglycemia (= 0.004) and low hemoglobin (= 0.023) are identified as adverse factors for developing severe pneumonia.
Symptoms such as hemoptysis, low lymphocyte count, and elevated procalcitonin or ferritin levels are associated with poor kidney transplant outcomes following COVID-19.
Simplified
INTRODUCTION: The aim of the study was to investigate the long-term effects of the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection and novel coronavirus disease (COVID-19) on prognosis of kidney transplant recipients.
METHODS: A 1-year retrospective study was carried out among 362 domestic kidney transplant recipients who were divided into observational (COVID-19) and control groups. Stratification analysis was then carried out to investigate whether repeated infections and infection severity could influence graft prognosis. Kaplan-Meier curves assessed 1-year graft survival, while one-way analysis of variance (ANOVA) compared graft function and laboratory parameters. Generalized estimating equations and repeated-measures ANOVA confirmed the magnitude of the impact of COVID-19 on kidney grafts. Generalized logistic regression and Cox regression established a model for analyzing COVID-19 risk factors. Meta-analysis and subgroup analysis were performed for validation.
RESULTS: Exposure of COVID-19 had a significant effect on graft function within 1 year (< 0.001), and this kind of effect was mostly brought by severer infections in the stratification analysis regarding graft survival rate (< 0.001), estimated glomerular filtration rate () level (< 0.001), and 1-year eGFR slope (= 0.014). Diagnostic model showed tacrolimus patients are less likely to get severe COVID-19 than cyclosporine (= 0.004). Hyperglycemia (= 0.004) and low hemoglobin (= 0.023) are adverse factors for severe pneumonia. Hemoptysis, hypo-lymphopenia, high procalcitonin and ferritin are linked to poor allograft outcomes with SARS-CoV-2 infection. p p p p p p p
CONCLUSIONS: COVID-19 severity is linked to poor kidney allograft prognosis. Hyperglycemia, low hemoglobin, and drug protocols including cyclosporine rather than tacrolimus are correlated with . Hemoptysis, low lymphocytes, high procalcitonin or ferritin were concerned with kidney allograft prognosis post-COVID-19.
Key numbers
< 0.001
Increase in Graft Function Impairment
Statistical significance for graft function impact due to COVID-19
0.004
Risk of Severe COVID-19
p-value indicating reduced risk associated with tacrolimus
0.004
Adverse Factors for Severe Pneumonia
p-value for hyperglycemia's impact on pneumonia severity
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