INTRODUCTION
Since 2019, the world has seen a rapid and wavelike spread of the coronavirus disease 2019(COVID-19). From 2019 to December 2022, more than 650 million confirmed cases and more than 6.6 million deaths have been reported globally. The Omicron variants originally reported in Southern Africa have spread globally at a significantly higher rate than the Delta variant in November 2021. It already proved to be the dominant influenza strain in most parts of the world at present[1].
Compared to the general population, Kidney transplant recipients(KTRs) are susceptible to multiple infectious diseases because they need to take immunosuppressive medication after kidney transplantation surgery[2-5]. KTRs always suffer from chronic illness such as high blood pressure or various chronic kidney disorder. As a result, they have higher rates of critically ill patients and mortality rates than the general population which call for high attention from experts in the field of kidney transplantation[6].
According to the researches by Montefiore Medical Center in New York and Columbia University Kidney Transplantation Project, the overall performance of COVID-19 in KTR is similar to that of the general population. The most common symptoms are fever, cough, dyspnea, fatigue, diarrhea and myalgia[7-8]. While a another previous researches showed that KTR may face more severe challenges than non-transplant patients. Based on a recent meta-analysis, transplant patients with COVID-19 had a higher risk (+57%) of intensive care unit admission than non-transplant patients[9]. In addition, research has shown that KTRs, as well as other solid organ transplant recipients (SOTR), the incidence of pneumonia after infection with Omicron was significantly higher than that of ordinary population, resulting the increased proportion of abnormal chest CT imaging. While there may not be significant differences in X-ray radiation detection, as for scattered and slight ground glass like shadow changes, the ordinary posterior anterior combined with lateral chest X-ray is difficult to detect [10].
Most KTRs have 2-3 high-risk factors, which belong to the category of high risk groups that exhibit severe or critically severe conditions, which call for immediately antiviral treatment according to the Diagnosis and Treatment scheme of COVID-19 (Version X) of China[2]. New neutralizing antibodies and antiviral drugs have been used in antiviral therapy nowadays[11-16]. The former includes tixagevimab and cilgavimab as well[17-18]. The latter includes Paxlovid, Azvudine (2’-deoxy-2’-β-fluoro-4’-azidocytidine) (FNC), nematvir, ritonavir, molnupiravir and so on[19].
To compare the differences of the diagnosis and treatment of KTRs and the general population infected with Omicron, we collected 194 kidney transplant patients (KTRs) and 516 patients in the general population who were followed up from December 2022 to January 2023 at The Third People’s Hospital of Shenzhen.