High Prevalence of Long-COVID Among Kidney Transplant Recipients: A Longitudinal Cohort Study

Amorim, Carlos Eduardo Neves; Gomes, Vinicius Lafico Teixeira; Cristelli, Marina Pontello; Viana, Laila Almeida; Corrêa, Hugo de Luca; Lima, Giérisson Brenno Borges; Silva, Flaviana Santos de Sousa; Lima, Gabriel Santos; Rosa, Thiago dos Santos; Nakamura, Monica Rika; Quintino, Priscilla Monteiro; Tedesco‐Silva, Hélio; Medina‐Pestana, José Osmar

doi:10.1097/tp.0000000000004359

Cited by 10 publications

(14 citation statements)

References 27 publications

(46 reference statements)

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“…In one study of kidney transplant recipients, the number of symptoms in acute COVID-19 illness was the only independent risk factor identified with development of PASC. 21 Severe presentation of acute COVID-19 appeared to be a strong predictor for the development of PASC. Severe acute COVID-19…”

Section: Discussionmentioning

confidence: 94%

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Post‐acute sequelae of COVID‐19 in solid organ transplant recipients

Sigler,

Covarrubias,

Chen

et al. 2023

Transplant Infectious Dis

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BackgroundPost‐acute sequelae of coronavirus disease 2019 (COVID‐19) (PASC), defined as prolonged symptoms following an episode of COVID‐19, is not well‐characterized in solid organ transplant recipients (SOTR). In this study, we aimed to assess the prevalence of PASC in SOTR, its descriptive characteristics, and associated risk factors.MethodsWe retrospectively identified SOTRs with acute COVID‐19 between June 1, 2020 and April 15, 2022, and abstracted demographic and medical history, characteristics of acute COVID‐19 illness, and COVID‐19 vaccination status. We defined PASC as ongoing/new symptoms present at 6 weeks or longer following acute COVID‐19 diagnosis.ResultsAmong 208 SOTRs with acute COVID‐19, 72 (35%) developed PASC. Common symptoms were respiratory symptoms (67%), headache (40%), and difficulty concentrating (10%). Severe acute COVID‐19 disease and presence of respiratory symptoms were associated with higher odds of PASC in multivariable analyses, while receipt of at least one COVID‐19 vaccination prior to transplantation was protective.ConclusionWe found that PASC occurs in about a third of SOTRs with acute COVID‐19 and has similar symptoms as described previously in immunocompetent hosts. Pre‐transplant vaccination may be protective. Further prospective multicenter studies are needed. image

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Section: Discussionmentioning

confidence: 94%

“…The fact that no other symptoms were significant in the development of PASC in our population bears further investigation. In one study of kidney transplant recipients, the number of symptoms in acute COVID‐19 illness was the only independent risk factor identified with development of PASC 21 …”

Section: Discussionmentioning

confidence: 99%

Post‐acute sequelae of COVID‐19 in solid organ transplant recipients

Sigler,

Covarrubias,

Chen

et al. 2023

Transplant Infectious Dis

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“…These conditions were defined as long COVID or PCC and the lack of standard methods for diagnosis until now causes an extreme heterogeneity in clinical manifestations and prevalence [30]. Factors such as age, comorbidities, need of mechanical ventilation or intensive care support during acute disease were controversially associated with PCC [31][32][33][34]. It may depend on heterogeneity of the cohorts, severity of symptoms collected and time of follow-up [31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

“…Factors such as age, comorbidities, need of mechanical ventilation or intensive care support during acute disease were controversially associated with PCC [31][32][33][34]. It may depend on heterogeneity of the cohorts, severity of symptoms collected and time of follow-up [31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study

et al. 2023

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Purpose Oral antivirals (nirmatrelvir/ritonavir and molnupiravir), intravenous short treatment of remdesivir and anti-SARS-CoV-2 monoclonal antibodies (mAbs) have been used for early COVID-19 treatments in high risk of disease progression patients. The term long COVID has been used to refer to a range of new, returning, or ongoing symptoms after SARS-CoV-2 infection. Little is known about the impact of such therapies on long COVID. Methods This is a retrospective observational study, including all outpatients evaluated from April 2021 to March 2022 in Brescia, Lombardy, northern Italy. Patients were stratified in three groups: (a) treated with mAbs, (b) treated with antivirals drugs and (c) controls (patients eligible for a or b who refused treatment). Data were collected at baseline and at month 1 and 3 (data on self-reported symptoms were collected using a telephone-administered questionnaire). We assessed early COVID-19 therapies effectiveness in preventing hospitalization, death at 1 or 3 months and persisting symptoms at 3 months after the onset of SARS-CoV-2 infection. Results A total of 649 patients were included in the study, of which 242 (37.3%) were treated with mAbs, 197 (30.3%) with antiviral drugs and 210 (32.4%) were not treated. Patients most frequently reported cerebro-cardiovascular diseases (36.7%) followed by obesity (22%). Overall, 29 patients (4.5%) died or were hospitalized at 1 or 3-month follow-up. Death or hospitalization was positively associated with older ages, with a significant linear trend (OR 3.05; 95% CI 1.16–8.06, for patients aged 80 or more years compared to those aged less than 65). Data on long COVID at 3 months were available for 323 (49.8%) patients. A positive association emerged for females compared to men, with an OR of 2.14 (95% CI 1.30–3.53) for any symptoms. Conversely, inverse associations were found for treatment groups as compared to the control one, with significant estimates among patients treated with antiviral drugs for any symptoms (OR 0.43, 95% CI 0.21–0.87) and patients treated with mAbs for any neuro-behavioral symptoms (OR 0.48, 95% CI 0.25–0.92). Conclusions We report beneficial effect of early use of anti-SARS-CoV-2 antivirals and mAbs on long COVID.

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“…These individuals encountered notable challenges in resuming normal activities, particularly in a work-related context. 6 Conversely, the omicron strains have introduced a distinct pattern of illness characterized by exceptionally high transmissibility but milder disease. 7,8 Furthermore, emerging evidence suggests that the omicron variant may be linked to a reduced occurrence of Long COVID in the general population.…”

Section: Introductionmentioning

confidence: 99%

Long COVID Among Kidney Transplant Recipients Appears to Be Attenuated During the Omicron Predominance

Amorim,

Cazetta,

Cristelli

et al. 2023

Transplantation

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Background. Omicron variant has been associated with milder cases of COVID-19 among kidney transplant recipients. However, little is known about postacute sequelae, referred to as Long COVID. Methods. Prospective, single-center cohort study investigating prevalence and risk factors for Long COVID among kidney transplant recipients during the omicron predominance in Brazil. The analysis included adult patients with confirmed SARS-CoV-2 infection between January 5, 2022, and July 18, 2022, were alive, had a functioning kidney transplant 3 mo after symptom onset, and answered a telephonic survey about physical complains of Long COVID. Results. From the 1529 eligible, 602 (39%) patients responded the survey. Sixteen percent reported a previous SARS-CoV-2 infection, and 85% had been fully vaccinated. The prevalence of Long COVID was 52%, with the most common complaints being weakness (46%), myalgia (41%), dizziness (33%), and headache (31%). Among employed patients, 94% were able to resume their normal work activities. In multivariable analysis, female gender (hazard ratio [HR], 2.14; 95% confidence interval [CI], 1.51-3.02; P < 0.0001), previous SARS-CoV-2 infection (HR, 3.55; 95% CI, 1.91-6.60; P < 0.0001), fatigue (HR, 2.32; 95% CI, 1.18-4.55; P = 0.014), myalgia (HR, 1.48; 95% CI, 1.03-2.15; P = 0.036) during the acute phase, and hospitalization because of COVID-19 (HR, 1.71; 95% CI, 1.06-2.76; P = 0.028) were independently associated with Long COVID. Conclusions. In the “omicron era,” Long COVID among kidney transplant recipients exhibited milder characteristics and had a less significant impact on their ability to resume normal life activities. The risk factors for persistent symptoms were similar to those observed in the general population except for the vaccination status, underscoring the importance of closer monitoring in special subgroups.

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High Prevalence of Long-COVID Among Kidney Transplant Recipients: A Longitudinal Cohort Study

Cited by 10 publications

References 27 publications

Post‐acute sequelae of COVID‐19 in solid organ transplant recipients

Post‐acute sequelae of COVID‐19 in solid organ transplant recipients

The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study

Long COVID Among Kidney Transplant Recipients Appears to Be Attenuated During the Omicron Predominance

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