Keywords
Kidney transplant
Fungal infections
Clinical features
Risk factors
Submitted : 2024-09-15
Accepted : 2024-09-30
Published : 2024-10-15
Abstract
Objective: To investigate the clinical features, outcomes, and risk factors of fungal infections in kidney transplant recipients (KTRs) as a result of coronavirus disease 2019 (COVID-19). Methods: We retrospectively analyzed 54 KTRs with COVID-19 who were hospitalized at the China-Japan Friendship Hospital from December 1, 2022, to April 1, 2023. With a mean age of 50 ± 12 years, there were 43 men and 11 women participated. For KTRs with COVID-19, we employed multivariate logistic regression analysis to identify the risk factors. Results: Twenty (37.0%) patients in this study had fungal infections as a result of COVID-19. Patients with fungal infections had significantly higher rates of mortality (50.0%, 10/20 vs. 2.9%, 1/34, P < 0.001), acute respiratory distress syndrome (ARDS) (65.0%, 13/20 vs. 26.5%, 9/34, P = 0.005), and acute kidney injury (AKI) (60%, 12/20 vs. 23.5%, 8/34, P = 0.007) than those without fungal infections. The result of the multivariate analysis showed that the incidence of fungal infections in KTRs with COVID-19 was independently correlated with age (increased by 10 years, OR = 2.221), history of diabetes mellitus (OR = 12.293), ARDS (OR = 12.849), and bacterial co-infections (OR = 30.461). Conclusion: Compared to KTRs without fungal infections, those with COVID-19-related fungal infections had worse clinical courses and less favorable results. The conditions including bacterial co-infections, ARDS, older age, and comorbidity of diabetes mellitus increased the incidence of secondary fungal infections.
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