A Cohort Study of the Long-Term Influences of SARS-CoV-2 on Kidney Allograft Outcomes in Chinese Recipients: 1-Year Follow-Up Experience

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 ca...

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Main Authors: Yisheng Ji, Shuang Fei, Hongsheng Ji, Fan OuYang, Runmin Ding, Li Sun, Hao Chen, Xiaobing Ju, Jun Tao, Zhijian Han, Mulong Du, Zijie Wang, Ruoyun Tan, Min Gu
Format: Article
Language:English
Published: Karger Publishers 2025-01-01
Series:Kidney Diseases
Online Access:https://karger.com/article/doi/10.1159/000543935
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author Yisheng Ji
Shuang Fei
Hongsheng Ji
Fan OuYang
Runmin Ding
Li Sun
Hao Chen
Xiaobing Ju
Jun Tao
Zhijian Han
Mulong Du
Zijie Wang
Ruoyun Tan
Min Gu
author_facet Yisheng Ji
Shuang Fei
Hongsheng Ji
Fan OuYang
Runmin Ding
Li Sun
Hao Chen
Xiaobing Ju
Jun Tao
Zhijian Han
Mulong Du
Zijie Wang
Ruoyun Tan
Min Gu
author_sort Yisheng Ji
collection DOAJ
description 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 (p < 0.001), and this kind of effect was mostly brought by severer infections in the stratification analysis regarding graft survival rate (p < 0.001), estimated glomerular filtration rate (eGFR) level (p < 0.001), and 1-year eGFR slope (p = 0.014). Diagnostic model showed tacrolimus patients are less likely to get severe COVID-19 than cyclosporine (p = 0.004). Hyperglycemia (p = 0.004) and low hemoglobin (p = 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. 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 COVID-19 pneumonia. Hemoptysis, low lymphocytes, high procalcitonin or ferritin were concerned with kidney allograft prognosis post-COVID-19.
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publishDate 2025-01-01
publisher Karger Publishers
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series Kidney Diseases
spelling doaj-art-8ec01ccd60aa4f7a97073f926c7a8e7b2025-08-20T03:49:41ZengKarger PublishersKidney Diseases2296-93572025-01-0111112814210.1159/000543935A Cohort Study of the Long-Term Influences of SARS-CoV-2 on Kidney Allograft Outcomes in Chinese Recipients: 1-Year Follow-Up ExperienceYisheng JiShuang FeiHongsheng JiFan OuYangRunmin DingLi SunHao ChenXiaobing JuJun TaoZhijian HanMulong DuZijie WangRuoyun TanMin Gu 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 (p < 0.001), and this kind of effect was mostly brought by severer infections in the stratification analysis regarding graft survival rate (p < 0.001), estimated glomerular filtration rate (eGFR) level (p < 0.001), and 1-year eGFR slope (p = 0.014). Diagnostic model showed tacrolimus patients are less likely to get severe COVID-19 than cyclosporine (p = 0.004). Hyperglycemia (p = 0.004) and low hemoglobin (p = 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. 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 COVID-19 pneumonia. Hemoptysis, low lymphocytes, high procalcitonin or ferritin were concerned with kidney allograft prognosis post-COVID-19.https://karger.com/article/doi/10.1159/000543935
spellingShingle Yisheng Ji
Shuang Fei
Hongsheng Ji
Fan OuYang
Runmin Ding
Li Sun
Hao Chen
Xiaobing Ju
Jun Tao
Zhijian Han
Mulong Du
Zijie Wang
Ruoyun Tan
Min Gu
A Cohort Study of the Long-Term Influences of SARS-CoV-2 on Kidney Allograft Outcomes in Chinese Recipients: 1-Year Follow-Up Experience
Kidney Diseases
title A Cohort Study of the Long-Term Influences of SARS-CoV-2 on Kidney Allograft Outcomes in Chinese Recipients: 1-Year Follow-Up Experience
title_full A Cohort Study of the Long-Term Influences of SARS-CoV-2 on Kidney Allograft Outcomes in Chinese Recipients: 1-Year Follow-Up Experience
title_fullStr A Cohort Study of the Long-Term Influences of SARS-CoV-2 on Kidney Allograft Outcomes in Chinese Recipients: 1-Year Follow-Up Experience
title_full_unstemmed A Cohort Study of the Long-Term Influences of SARS-CoV-2 on Kidney Allograft Outcomes in Chinese Recipients: 1-Year Follow-Up Experience
title_short A Cohort Study of the Long-Term Influences of SARS-CoV-2 on Kidney Allograft Outcomes in Chinese Recipients: 1-Year Follow-Up Experience
title_sort cohort study of the long term influences of sars cov 2 on kidney allograft outcomes in chinese recipients 1 year follow up experience
url https://karger.com/article/doi/10.1159/000543935
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