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

Area of Science:

• Nephrology
• Infectious Diseases
• Transplantation Immunology

Background:

• COVID-19 poses a significant mortality risk to renal transplant recipients.
• Clinical outcomes in kidney transplant recipients with COVID-19 show unexplained variations.
• Cytomegalovirus (CMV) infection is a potential factor influencing COVID-19 outcomes in transplant patients.

Purpose of the Study:

• To investigate the prevalence of CMV viremia in kidney transplant recipients with and without COVID-19.
• To determine if CMV infection is associated with COVID-19 diagnosis in this patient population.

Main Methods:

• 191 kidney transplant recipients were analyzed, divided into COVID-19 positive (83) and negative (108) groups.
• CMV DNA levels were quantified in all participants.
• CMV positivity rates were compared between the two groups using logistic regression and multivariate analysis.

Main Results:

• CMV viremia was significantly higher in kidney transplant recipients with COVID-19 (15/83) compared to those without (4/108) (P = .001).
• CMV positivity was independently associated with COVID-19 infection.
• Lymphocyte count and estimated glomerular filtration rate (eGFR) were negatively correlated with COVID-19 infection.

Conclusions:

• CMV infection may coincide with or follow COVID-19 in kidney transplant recipients, potentially increasing morbidity and mortality.
• Routine screening for CMV and prompt treatment are recommended for high-risk transplant patients to mitigate mortality.