The Other Pandemic From the Pandemic: A Higher Frequency of Long COVID After Omicron in Kidney Transplant Recipients

Abstract

S ince it was first described, long coronavirus disease 2019 (COVID-19) has posed a vexing challenge for patients and healthcare providers, with significant lingering morbidity. 1 The absence of a consistent clinical definition has led to varying prevalence estimates. These estimates range from 8% of organ recipients with persistent symptoms 6 mo after infection, when self-reported symptoms are periodically assessed, up to 70% when the definition includes dyspnea and symptoms are only evaluated once. 2,3 One intriguing aspect amid the evolving dynamics of the severe acute respiratory syndrome coronavirus 2 strains has been the relationship between the virus variant and the risk of long COVID-19. In addition to its reduced clinical severity, Omicron was associated with lower rates of long COVID-19 in the general population. 4 Whether this trend extended to solid organ transplant recipients remained uncertain until this study by Amorin et al. 5 This prospective, single-center, cohort study was conducted at the Hospital do Rim, Fundação Oswaldo Ramos, in São Paulo, Brazil from January 5, 2022, to July 18, 2022. The study revealed that of 602 kidney transplant recipients who contracted COVID-19 and subsequently responded to their telephone survey (39% of the 1529 total), a staggering 52% had long COVID-19 symptoms, which included weakness, myalgia, dizziness, and headaches among the most frequent complaints. Interestingly, the authors reported that being admitted to the hospital (hazard ratio [HR] 1.7) or having symptoms such as fatigue and myalgia during the acute phase of infection (HR 2.32 and 1.48, respectively) were independent risk factors for long COVID-19; however, the authors did not find an association between the risk of long COVID-19 and previous vaccination. Although we often assume that immunity from prior infection may be