COVID-19 Infection May Lead to Increased CMV Infection in Renal Transplant Recipients

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-04-30 DOI:10.1016/j.transproceed.2025.03.004

Banu Yılmaz , Sibel Ersan , Gül Mingsar , Mehmet Tanrısev , Hülya Çolak , Orçun Ural

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引用次数: 0

Abstract

Background

The COVID-19 pandemic has caused significant mortality and morbidity, especially in renal transplant recipients. The mortality and hospitalization rate of COVID-19 infected transplant recipients is much higher than in the healthy population. Although progress has been made in the management of COVID-19 in renal transplant recipients, there are still unexplained clinical differences among patients. We think that cytomegalovirus (CMV) infection may also play a role in this clinical difference in COVID-19 infected transplant recipients. For this purpose, we aimed to screen for the presence of CMV viremia or infection in kidney transplant patient groups who were and were not diagnosed with COVID-19 in the last year.

Method

We included 191 consecutive kidney transplant recipients followed in our transplant clinic. The patients were divided into two groups according to whether they had COVID-19 infection or not in the last 1 year. CMV DNA levels were tested in the whole patients’ groups. We compared CMV positivity rates in patients with and without COVID-19.

Results

There were 83 patients who had COVID-19 and 108 patients who did not. Whereas CMV viremia was detected in 15 transplant recipients with COVID-19 infection, CMV viremia was detected in 4 patients who did not have COVID-19 (P = .001, logistic regression = 4.8, 95% confidence interval [CI] = 1328–17,103; Figure 1).There was no difference in terms of immunosuppressive therapy, steroid use, duration, and type of transplantation. The COVID-19 negative and positive groups were similar in lymphocyte and leukocyte counts (Table 1). In the multivariate analysis, CMV positivity was found to be positively associated with COVID-19 infection but lymphocyte count and estimated glomerular filtration rate (eGFR) were found to be independently and negatively correlated.

Conclusions

CMV infection may accompany COVID-19 or may occur in the post-COVID-19 period. It can cause increased morbidity and mortality. Routine screening and early treatment for CMV may reduce mortality in high-risk group.

查看原文本刊更多论文

COVID-19感染可能导致肾移植受者巨细胞病毒感染增加。

背景：COVID-19大流行已造成显著的死亡率和发病率，特别是在肾移植受者中。COVID-19感染移植受者的死亡率和住院率远高于健康人群。尽管肾移植受者COVID-19的管理取得了进展，但患者之间仍存在无法解释的临床差异。我们认为巨细胞病毒（CMV）感染也可能在COVID-19感染移植受者的临床差异中发挥作用。为此，我们的目的是筛查去年确诊和未确诊为COVID-19的肾移植患者组中巨细胞病毒血症或感染的存在。方法：纳入我院移植门诊191例连续肾移植受者。根据患者近1年内是否感染COVID-19分为两组。在所有患者组中检测巨细胞病毒DNA水平。我们比较了患有和未患有COVID-19的患者的CMV阳性率。结果：新冠肺炎患者83例，未感染患者108例。在15例感染COVID-19的移植受者中检测到CMV病毒血症，在4例未感染COVID-19的移植受者中检测到CMV病毒血症(P = .001， logistic回归= 4.8,95%可信区间[CI] = 1328-17,103；图1)。在免疫抑制治疗、类固醇使用、持续时间和移植类型方面没有差异。阴性组和阳性组淋巴细胞和白细胞计数相似（表1）。在多因素分析中，CMV阳性与COVID-19感染呈正相关，但淋巴细胞计数和估计的肾小球滤过率（eGFR）独立负相关。结论：巨细胞病毒感染可能伴随COVID-19，也可能发生在COVID-19后时期。它会导致发病率和死亡率增加。巨细胞病毒的常规筛查和早期治疗可降低高危人群的死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.