{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T02:16:38Z","timestamp":1773368198488,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T00:00:00Z","timestamp":1595289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>With COVID\u201019 pandemic, concerns about kidney transplant recipients are rising. However, the incidence, clinical course, outcome, and predictive factors of disease severity are obscured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We describe clinical and laboratory manifestations, radiologic findings, clinical course, and finally outcome of kidney transplant recipients with COVID\u201019 pneumonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2493 kidney transplant recipients under follow\u2010up in our clinic, 19 cases (4 cases diagnosed based on radiologic findings) were admitted. The mean age of patients was 47.6\u00a0\u00b1\u00a012.4\u00a0years, and the mean time from transplantation was 115.6\u00a0\u00b1\u00a070.3\u00a0months. Lymphopenia and eosinopenia were 84.2% and 78.9%, respectively. Nine patients did not survive the hospital course. History of acute rejection during the past 12\u00a0months, diabetes, higher N\/L ratio, lower platelet count, elevated N\/L x CRP, higher levels of LDH, positive D\u2010dimer, higher troponin, and prolonged PT were associated with mortality. Among patients with positive COVID\u201019 test, history of acute rejection, low platelet count, and positive D\u2010dimer were associated with poor outcome. Treatment with cyclosporine was associated with better clinical outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low rate of admission in transplant recipients specially in the very first years of transplantation might be due to protective effects of immunosuppressive agents against cytokine storm or modification of immunity function. We suggest evaluation of T\u2010cell number, function, and cytokine profile as a guide to manage COVID\u201019 mainly in patients with higher risk of mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13406","type":"journal-article","created":{"date-parts":[[2020,7,12]],"date-time":"2020-07-12T06:56:58Z","timestamp":1594537018000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Low rate of COVID\u201019 pneumonia in kidney transplant recipients\u2014A battle between infection and immune response?"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8274-397X","authenticated-orcid":false,"given":"Maryam","family":"Ghaffari Rahbar","sequence":"first","affiliation":[{"name":"Department of Nephrology Shahid Labbafinejad Medical Center Shahid Beheshti University of Medical Sciences Tehran Iran"},{"name":"Chronic Kidney Disease Research Center Shahid Beheshti University of Medical 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