Prevalence and Associated Factors of Anxiety and Depressive Symptoms Among Kidney Transplant Recipients In the Post- COVID-19 Era: A Cross-Sectional Study in China

Background Anxiety and depression are highly prevalent and disabling mental disorders that often coexist. Kidney transplant recipients are at high risk of anxiety and depression, especially during the COVID-19 pandemic. However, studies focusing on depression and anxiety among kidney transplant recipients in the post-COVID-19 era are lacking. Objective This study aimed to analyze the prevalence and risk factors associated with anxiety symptoms alone (ASA), depressive symptoms alone (DSA), and comorbid anxiety and depressive symptoms (CADS) in kidney transplant recipients after the COVID-19 pandemic. Methods A cross-sectional survey was conducted among kidney transplant recipients in a tertiary hospital in Hunan, China, from December 2022 to December 2023. Anxiety and depressive symptoms were assessed using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), based on which participants were divided into four groups: normal (no anxiety or depressive symptoms), ASA, DSA, and CADS. Clinical characteristics were compared between the groups, and the risk factors associated with ASA, DSA, and CADS were analyzed using multiple logistic regression. Results A total of 517 kidney transplant recipients were enrolled in this study, and 321 (62.1%) had neither anxiety nor depression symptoms. ASA was identified in 3.7% of recipients (n = 19), DSA in 20.3% (n = 105), and CADS in 13.9% (n = 72). Multiple logistic regression showed that rejection was positively associated with ASA, and vaccination was negatively associated with DSA. Younger age, transplant nephritis/nephropathy, a history of postoperative pulmonary infection, and rejection were positively associated with CADS. Conclusion In the post-COVID-19 era, anxiety and depressive symptoms remain prevalent among kidney transplant recipients and are associated with various factors. Our findings provide helpful guidance to develop targeted and effective interventions based on anxiety and depressive status to improve their mental health.