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.