Comparative Analysis of Upper Respiratory Viral Infections in Kidney Transplant Recipients and the Immunocompetent...

This study aimed to compare the clinical, laboratory, and virology profiles of pediatric kidney transplant recipients and immunocompetent children presenting with upper respiratory tract infection, evaluated using multiplex viral polymerase chain reaction panels.

This single -center retrospective cohort study included 31 kidney transplant recipients (aged 7 -16 years ) and 80 age -matched immunocompetent children who presented with upper respiratory tract infection at Başkent University Hospital from January 2023 to March 2025. Demographic, clinical, and laboratory data, including complete blood count, renal and liver function tests, and C -reactive protein, were recorded. Viral pathogens were identified using multiplex polymerase chain reaction. Inflammatory indexes, such as the neutrophil -to -lymphocyte ratio, platelet -to -lymphocyte ratio, and systemic immune -inflammation index, were calculated. We used SPSS software (version 26.0; IBM ) for all statistical analyses, and 2 -sided P < .05 was considered significant.

A total of 111 pediatric patients with upper respiratory tract infection were included in the study. Kidney transplant recipients were significantly older than patients in the control group without transplant (median 12.0 vs 7.5 years; P < .001 ). The neutrophil -to -lymphocyte ratio was higher (P = .001 ) and platelet counts were lower (P = .004 ) in the kidney transplant group. Renal (blood urea nitrogen, creatinine, uric acid ) and hepatic (aspartate aminotransferase and alanine aminotransferase ) parameters were significantly elevated in kidney transplant recipients (all P < .01 ). We detected SARS -CoV -2 exclusively in the kidney transplant group (35.5 %, P < .001 ), whereas other viral agents showed similar distributions between groups. Hospitalization rates and duration of hospital stay did not differ significantly.

Pediatric kidney transplant recipients exhibit distinct inflammatory and biochemical profiles during upper respiratory tract infection compared with healthy peers but show comparable clinical outcomes. Early molecular diagnosis, vigilant monitoring, and preventive strategies such as vaccination remain essential to optimize infection management in this vulnerable population.