tetano
Editor, Senior Moderator
Clin Transplant Res
. 2025 Feb 6.
doi: 10.4285/ctr.24.0045. Online ahead of print. Predictors of moderate, severe, and critical COVID-19 infection in a largely vaccinated kidney transplant recipient cohort during the Omicron era: the importance of timely booster vaccinations and early presentation to care
Cherie Le Si Gan[SUP] 1 [/SUP], Shimin Jasmine Chung[SUP] 1 2 [/SUP], Quan Yao Ho[SUP] 2 3 [/SUP], Thuan Tong Tan[SUP] 1 2 [/SUP], Ban Hock Tan[SUP] 1 2 4 [/SUP], Ian Tatt Liew[SUP] 2 3 [/SUP], Carolyn Shan-Yeu Tien[SUP] 2 3 [/SUP], Sobhana Thangaraju[SUP] 2 3 [/SUP], Terence Kee[SUP] 2 3 [/SUP]
Affiliations
Background: Kidney transplant recipients (KTRs) are at risk of coronavirus disease 2019 (COVID-19) complications and mortality. This study examined factors associated with moderate, severe, or critical COVID-19 infection among KTRs during the Omicron-predominant period.
Methods: This single-center retrospective study included KTRs aged ≥18 years diagnosed with COVID-19 between January 1, 2022, and December 31, 2023. Mild infection was defined as symptomatic illness without lower respiratory tract infection (LRTI); moderate infection as LRTI without hypoxia; severe infection as oxygen saturation <94% on room air; and critical infection as respiratory failure, septic shock, or multiple organ dysfunction. We compared the characteristics of KTRs with asymptomatic or mild COVID-19 versus those with moderate to critical disease. Logistic regression analysis was performed to identify factors associated with moderate to critical illness.
Results: Most KTRs (94.4%) had received three or more vaccine doses. Of 603 episodes of COVID-19 infection during the study period, 554 (91.9%) were asymptomatic or mild, while 49 (8.1%) were moderate to critical. Multivariate analysis revealed that older age (adjusted odds ratio [aOR], 1.037; 95% confidence interval [CI], 1.006-1.069) and longer symptom duration before seeking care (aOR, 1.288; 95% CI, 1.155-1.436) were associated with higher odds of moderate to critical disease. Protective factors included receiving a vaccine booster within the past year (aOR, 0.414; 95% CI, 0.212-0.809) and higher glomerular filtration rate (aOR, 0.971; 95% CI, 0.956-0.986).
Conclusions: KTRs should seek care early if infected with COVID-19 and keep their COVID-19 vaccine boosters updated within 1 year of the last dose.
Keywords: COVID-19; Kidney transplantation; Omicron; SARS-CoV-2; Vaccination.
. 2025 Feb 6.
doi: 10.4285/ctr.24.0045. Online ahead of print. Predictors of moderate, severe, and critical COVID-19 infection in a largely vaccinated kidney transplant recipient cohort during the Omicron era: the importance of timely booster vaccinations and early presentation to care
Cherie Le Si Gan[SUP] 1 [/SUP], Shimin Jasmine Chung[SUP] 1 2 [/SUP], Quan Yao Ho[SUP] 2 3 [/SUP], Thuan Tong Tan[SUP] 1 2 [/SUP], Ban Hock Tan[SUP] 1 2 4 [/SUP], Ian Tatt Liew[SUP] 2 3 [/SUP], Carolyn Shan-Yeu Tien[SUP] 2 3 [/SUP], Sobhana Thangaraju[SUP] 2 3 [/SUP], Terence Kee[SUP] 2 3 [/SUP]
Affiliations
- PMID: 39909823
- DOI: 10.4285/ctr.24.0045
Background: Kidney transplant recipients (KTRs) are at risk of coronavirus disease 2019 (COVID-19) complications and mortality. This study examined factors associated with moderate, severe, or critical COVID-19 infection among KTRs during the Omicron-predominant period.
Methods: This single-center retrospective study included KTRs aged ≥18 years diagnosed with COVID-19 between January 1, 2022, and December 31, 2023. Mild infection was defined as symptomatic illness without lower respiratory tract infection (LRTI); moderate infection as LRTI without hypoxia; severe infection as oxygen saturation <94% on room air; and critical infection as respiratory failure, septic shock, or multiple organ dysfunction. We compared the characteristics of KTRs with asymptomatic or mild COVID-19 versus those with moderate to critical disease. Logistic regression analysis was performed to identify factors associated with moderate to critical illness.
Results: Most KTRs (94.4%) had received three or more vaccine doses. Of 603 episodes of COVID-19 infection during the study period, 554 (91.9%) were asymptomatic or mild, while 49 (8.1%) were moderate to critical. Multivariate analysis revealed that older age (adjusted odds ratio [aOR], 1.037; 95% confidence interval [CI], 1.006-1.069) and longer symptom duration before seeking care (aOR, 1.288; 95% CI, 1.155-1.436) were associated with higher odds of moderate to critical disease. Protective factors included receiving a vaccine booster within the past year (aOR, 0.414; 95% CI, 0.212-0.809) and higher glomerular filtration rate (aOR, 0.971; 95% CI, 0.956-0.986).
Conclusions: KTRs should seek care early if infected with COVID-19 and keep their COVID-19 vaccine boosters updated within 1 year of the last dose.
Keywords: COVID-19; Kidney transplantation; Omicron; SARS-CoV-2; Vaccination.