Investigators have identified risk factors for COVID-19-related mortality among kidney transplant recipients, including intubation and mechanical ventilation.
Among 218 kidney transplant recipients diagnosed with COVID-19 at a single center in India from April 2020 to July 2021, 30 died. Investigators matched and compared the 30 deceased patients with 188 survivors by age, sex, blood group, living or deceased donor transplant type, transplant duration, comorbidities, immunosuppression, hospitalization vs home care, and history of graft function, infections, acute kidney injury, and related therapies.
Adjusted multinomial logistic regression analyses showed that intubation and mechanical ventilation, high oxygen requirement, coinfection, and diarrhea were significantly associated with 326.1-, 36.6-, 19.9, and 9.1-fold increased odds of mortality in kidney transplant recipients with COVID-19, Deepesh B. Kenwar, MBBS, MS, of Post Graduate Institute of Medical Education & Research in Chandigarh, India, and colleagues reported in BMC Nephrology. The rate of coinfection was 12.4%. Among deceased individuals, cytomegalovirus (CMV) was the most common pathogen.
“An aggressive approach has to be taken for an early diagnosis and therapeutic intervention of associated infections,” Dr Kenwar’s team concluded.
In univariate analyses, antirejection therapy, lymphopenia, and requirement for renal replacement therapy were also associated with worse outcomes.
“Routine screening of patients with severe or persistent lymphopenia for the presence of CMV infection might help in early diagnosis and timely intervention,” the authors wrote.
Mortality did not differ by transplant type.
Choudhary D, Kenwar D, Sharma A, et al. Risk factors for mortality in kidney transplant recipients with COVID‐19: a single centre experience and case-control study. BMC Nephrol. Published July 7, 2022. 23(1):241. doi:10.1186/s12882-022-02821-8