Preexisting renal graft dysfunction as a major risk factor for SARS-CoV-2 Omicron variant pneumonia: A postinfection cross-sectional study of 312 immunosuppressed renal transplant recipients

Background SARS-CoV-2 pneumonia poses significant challenges to global health systems, particularly in severe and critical cases. Immunosuppressed renal transplant recipients appear to be at particularly high risk for severe or critical COVID-19 illness. However, few studies elucidated risk factors of SARS-CoV-2 pneumonia in renal transplant recipients with COVID-19.Methods A post-infection cross-sectional survey was conducted in 312 renal transplant recipients and 503 age and sex matched controls to explore risk factors for SARS-CoV-2 pneumonia in immunosuppressed renal transplant recipients.Results The results showed renal transplant recipients had a much higher incidence of SARS-CoV-2 pneumonia (48.1%) after infection with the SARS-CoV-2 Omicron variant compared with controls (5.6%). Multivariate binary logistic regression analysis identified older age, lower Ccr before infection, and higher dose of prednisone before infection were risk factors for SARS-CoV-2 pneumonia in renal transplant recipients. Pre-existing renal dysfunction was a major risk factor for SARS-CoV-2 pneumonia with an odds ratio (OR) value of 3.27 (1.01-10.61).Conclusions Pre-existing renal graft dysfunction was a major risk factor for SARS-CoV-2 Omicron variant pneumonia. It is suggested that high-risk renal transplant recipients should undergo CT scanning within 14 days after infection with SARS-CoV-2.