Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

COVID-19 Outcomes in Kidney Transplant Recipients in a German Transplant Center

Michael Mikhailov
* ORCID logo ,
Klemens Budde
* ORCID logo ,
Fabian Halleck
* ,
Georgios Eleftheriadis
* ,
Marcel Naik
* ORCID logo ,
Eva Schrezenmeier
* ,
Friederike Bachmann
* ,
Mira Choi
* ORCID logo ,
Wiebke Duettmann
* ORCID logo ,
Ellen Von Hoerschelmann
* ,
Nadine Koch
* ,
Lutz Liefeldt
* ORCID logo ,
Christian Lücht
* ,
Henriette Straub-Hohenbleicher
* ,
Johannes Waiser
* ,
Ulrike Weber
* ,
Bianca Zukunft
* ,
Bilgin Osmanodja
* ORCID logo
Version 1 : Received: 11 August 2023 / Approved: 14 August 2023 / Online: 15 August 2023 (08:32:22 CEST)

A peer-reviewed article of this Preprint also exists.

Mikhailov, M.; Budde, K.; Halleck, F.; Eleftheriadis, G.; Naik, M.G.; Schrezenmeier, E.; Bachmann, F.; Choi, M.; Duettmann, W.; von Hoerschelmann, E.; Koch, N.; Liefeldt, L.; Lücht, C.; Straub-Hohenbleicher, H.; Waiser, J.; Weber, U.; Zukunft, B.; Osmanodja, B. COVID-19 Outcomes in Kidney Transplant Recipients in a German Transplant Center. J. Clin. Med. 2023, 12, 6103. Mikhailov, M.; Budde, K.; Halleck, F.; Eleftheriadis, G.; Naik, M.G.; Schrezenmeier, E.; Bachmann, F.; Choi, M.; Duettmann, W.; von Hoerschelmann, E.; Koch, N.; Liefeldt, L.; Lücht, C.; Straub-Hohenbleicher, H.; Waiser, J.; Weber, U.; Zukunft, B.; Osmanodja, B. COVID-19 Outcomes in Kidney Transplant Recipients in a German Transplant Center. J. Clin. Med. 2023, 12, 6103.

Abstract

Kidney transplant recipients (KTR) show higher morbidity and mortality from COVID-19 than the general population and have an impaired response to vaccination. We analyzed COVID-19 incidence and clinical outcomes in a single-center cohort of approximately 2500 KTR. Between February 1, 2020 and July 1, 2022, 578 KTR were infected with SARS-CoV-2, with 25 (4%) recurrent infections. 208 KTR (36%) were hospitalized, and 39 (7%) died. Among vaccinated patients, infection with the Omicron variant had a mortality of 2%. Unvaccinated patients infected with the Omicron variant showed mortality (9% vs. 11%) and morbidity (hospitalization 52% vs. 54%, ICU-admission 12% vs. 18%) comparable to the pre-Omicron era. Multivariable analysis revealed, being unvaccinated (OR = 2.15, 95% CI [1.38, 3.35]), infection in the pre-Omicron era (OR = 3.06, 95% CI [1.92, 4.87]), and higher patient age (OR = 1.04, 95% CI [1.03, 1.06]) are independent risk factors for COVID-19 hospitalization, whereas steroid-free immunosuppressive regimen was found to reduce the risk of COVID-19 hospitalization (OR = 0.51, 95% CI [0.33, 0.79]). This suggests that both, virological changes in the Omicron variant and vaccination, reduce the risk for morbidity and mortality from COVID-19 in KTR. Our data extend the knowledge from the general population to KTR and provide important insights into outcome during the Omicron era.

Keywords

kidney transplant recipients, immunosuppression, vaccination, SARS-CoV-2, COVID-19, Omicron

Subject

Medicine and Pharmacology, Transplantation

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download PDF

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our Diversity statement.

Leave a public comment
Send a private comment to the author(s)
* All users must log in before leaving a comment
Views 0
Downloads 0
Comments 0
Metrics 0
Get PDF Cite Share 0
Bookmark BibSonomy Mendeley Reddit Delicious
×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.