Comparative study of COVID-19 infection in renal transplant recipients and non transplant recipients

To analyse the difference in COVID-19 infection between kidney transplant patients and non-transplant patients. We included post-transplant patients with COVID-19 infection who attended Shenzhen No. 3 Hospital from December 2022 to February 2023, and enrolled the general population with COVID-19 infection who were hospitalized during the same period, matched by age and gender. They were divided into Kidney Transplant Recipients group (KTR) (n=194) and Non-Kidney Transplant Recipients Group（NKTR）(n=516) and the basic information, clinical symptoms, laboratory data, treatments and outcomes of these two groups were compared. The proportion of the renal transplant population classified as severe and critical was 15.5%, which was significantly higher than that in NKTR group (P < 0.05); the proportion of patients with pneumonia was also significantly higher than that in NKTR group. The mean maximum fever temperature was slightly higher in the NKTR( P <0.001);Kidney transplant population having lower absolute lymphocyte counts on admission and 7 days after admission than the general population, with statistically significant differences（ P <0.001, P ＜0.001). The use of intravenous hormones was significantly higher (42.8% vs. 6.0%, p=0.000), as was the use of small molecules such as Azvudine and Paxlovid, compared to the general population. A total of 10 patients in the included population required ICU admission, all in the KTR group; six patients experienced death, also in the renal transplant group. Conclusion: Post-transplant COVID-19 infections are more severe and require hormonal and small molecule antiviral therapy, and the prognosis is worse than in the general population. Trial registration This study was approved and supervised by the ethics committee of the Third People's Hospital of Shenzhen (approval number 2023-036-02) and firstly registered in 03/07/2023, registration number was NCT05926076.