2025/01/29 by Alexandra Nowak, Aurora Caldinelli, Mårten Segelmark +7 · 1 voice
Medicine · #COVID-19 Clinical Research Studies #Renal Transplantation Outcomes and Treatments #SARS-CoV-2 and COVID-19 Research
paper · doi:10.1093/ckj/sfaf030
openalex publication_date 2025/01/29 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/28
ABSTRACT Background Current knowledge about risk factors for severe COVID-19 among kidney transplant recipients stem from meta-analyses of small or regional studies. Methods All kidney transplant recipients in Sweden as of 1 January 2020 (n = 5824) were followed during the first 2 years of the pandemic. Data from the Swedish Renal Registry and linked health care registries were analyzed by multivariable adjusted logistic regression to identify risk factors for severe COVID-19, defined as hospitalization or death due to COVID-19. Results Male sex increased the risk of severe COVID-19. While many comorbidities were associated with increased risk, their significance diminished after adjustment for other factors. Kidney transplant recipients of working age, 49–58 years adjusted odds ratio (aOR) 2.32 (95% CI 1.53–3.51) and 59–68 years aOR (1.92; 1.26–2.91) had the highest risk compared to the youngest age group (18–38 years). Compared to recently (<1 year) transplanted patients, those transplanted >5 years ago had a lower risk of severe COVID-19 (aOR 0.52; 0.36–0.75 for 6–10 years; aOR 0.57; 0.41–0.79 for >10 years). Longer pre-transplant dialysis vintage (aOR1-year 1.04; 1.01–1.06) and deceased donor kidneys (aOR 1.41; 1.09–1.84) increased the risk. Immunosuppression with mycophenolate mofetil (aOR 1.47, 95% CI 1.08–1.99) and proton pump inhibitor use (aOR 1.58, 95% CI 1.24–2.01) were strongly associated with severe COVID-19. Conclusions While kidney transplant recipients share risk factors with the general population, working age groups were at the highest risk, unlike in the general population. These findings emphasize the need for targeted prevention and treatment strategies for kidney transplant recipients in future pandemics.