{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:52:23Z","timestamp":1792180343586,"version":"4.4.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Virol J"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Coronavirus disease 2019 (COVID-19), a novel disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to millions of deaths worldwide. Kidney transplant recipients (KTRs) are a fragile population due to their immunosuppressed status. However, there are limited studies available comparing this population with the general population regarding clinical symptoms, and laboratory and imaging features as well as disease severity and clinical outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 24 KTRs and 40 patients from the general population (control group) were enrolled after applying exclusion criteria. Clinical symptoms, laboratory values, and lung involvement patterns in high-resolution computed tomography (HRCT) were compared between KTRs with COVID-19 and their counterparts from the general population. Moreover, the category of disease severity and adverse outcomes such as intensive care unit (ICU) admission, mechanical ventilation (MV),\u00a0and mortality rate were also compared between these two groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Hypertension was significantly higher among KTRs. Dyspnea was significantly more among the control group (<jats:italic>P<\/jats:italic>\u2009=\u20090.045). There was no significant difference in the rest of clinical symptoms (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). There was no significant difference in CT features as well, except pleural effusion, which was more prevalent in the control group. A lower absolute lymphocytic count (ALC) and platelet count were observed in KTRs. Renal transplant recipients (RTRs) had a higher elevation in creatinine level than their counterparts. The ICU admission, MV, duration of hospital stay, and mortality as adverse outcomes were not significantly different between the KTR and control groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In conclusion, there was no significant difference in the severity and risk of adverse outcomes, including MV, ICU admission, and mortality between KTRs under chronic immunosuppression and the control group.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12985-021-01713-x","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T11:02:33Z","timestamp":1638874953000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["COVID-19 in renal transplant recipients and general population: a comparative study of clinical, laboratory, and radiological features, severity, and outcome"],"prefix":"10.1186","volume":"18","author":[{"given":"Ali","family":"Monfared","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Akhondzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahsa","family":"Mousazadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atefeh","family":"Jafari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masoud","family":"Khosravi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadkazem","family":"Lebadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pegah","family":"Aghajanzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yalda","family":"Haghdar-Saheli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Movassaghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham","family":"Ramezanzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzaneh","family":"Shobeirian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehsan","family":"Kazemnezhad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samaneh","family":"Esmaeili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"key":"1713_CR1","unstructured":"World Health Organization. Public Health Emergency of International Concern (PHEIC). Who. Published online 2020:1\u201310."},{"issue":"6","key":"1713_CR2","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1002\/jmv.25748","volume":"92","author":"Y Wang","year":"2020","unstructured":"Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol. 2020;92(6):568\u201376.","journal-title":"J Med Virol"},{"key":"1713_CR3","volume-title":"How should I manage immunosuppression in a kidney transplant patient with COVID-19?","author":"U Maggiore","year":"2020","unstructured":"Maggiore U, Abramowicz D, Crespo M, et al. How should I manage immunosuppression in a kidney transplant patient with COVID-19? An ERA-EDTA DESCARTES expert opinion: Published online; 2020."},{"issue":"11","key":"1713_CR4","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1001\/jama.2020.1585","volume":"323","author":"D Wang","year":"2020","unstructured":"Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus\u2013infected pneumonia in Wuhan China. Jama. 2020;323(11):1061\u20139.","journal-title":"Jama"},{"issue":"10","key":"1713_CR5","doi-asserted-by":"publisher","first-page":"2876","DOI":"10.1111\/ajt.16062","volume":"20","author":"J Tschopp","year":"2020","unstructured":"Tschopp J, L\u2019Huillier AG, Mombelli M, et al. First experience of SARS-CoV-2 infections in solid organ transplant recipients in the Swiss Transplant Cohort Study. Am J Transplant. 2020;20(10):2876\u201382.","journal-title":"Am J Transplant"},{"key":"1713_CR6","doi-asserted-by":"crossref","unstructured":"Kataria A, Yakubu I, Winstead R, Gowda M, Gupta G. COVID-19 in Kidney transplantation: epidemiology, management considerations, and the impact on kidney transplant practice. Transplant Direct. 2020;6(8):e582.","DOI":"10.1097\/TXD.0000000000001031"},{"issue":"8","key":"1713_CR7","doi-asserted-by":"publisher","first-page":"1174","DOI":"10.2215\/CJN.05170420","volume":"15","author":"SA Husain","year":"2020","unstructured":"Husain SA, Dube G, Morris H, et al. Early outcomes of outpatient management of kidney transplant recipients with coronavirus disease 2019. Clin J Am Soc Nephrol. 2020;15(8):1174\u20138.","journal-title":"Clin J Am Soc Nephrol"},{"issue":"25","key":"1713_CR8","doi-asserted-by":"publisher","first-page":"2475","DOI":"10.1056\/NEJMc2011117","volume":"382","author":"E Akalin","year":"2020","unstructured":"Akalin E, Azzi Y, Bartash R, et al. Covid-19 and kidney transplantation. N Engl J Med. 2020;382(25):2475\u20137.","journal-title":"N Engl J Med"},{"issue":"2","key":"1713_CR9","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.eururo.2020.04.064","volume":"78","author":"A Abrishami","year":"2020","unstructured":"Abrishami A, Samavat S, Behnam B, Arab-Ahmadi M, Nafar M, Taheri MS. Clinical course, imaging features, and outcomes of COVID-19 in kidney transplant recipients. Eur Urol. 2020;78(2):281\u20136.","journal-title":"Eur Urol"},{"issue":"11","key":"1713_CR10","doi-asserted-by":"publisher","first-page":"3061","DOI":"10.1111\/ajt.16280","volume":"20","author":"MZ Molnar","year":"2020","unstructured":"Molnar MZ, Bhalla A, Azhar A, et al. Outcomes of critically ill solid organ transplant patients with COVID-19 in the United States. Am J Transplant. 2020;20(11):3061\u201371.","journal-title":"Am J Transplant"},{"issue":"10","key":"1713_CR11","doi-asserted-by":"publisher","first-page":"2413","DOI":"10.1681\/ASN.2020050639","volume":"31","author":"M Elias","year":"2020","unstructured":"Elias M, Pievani D, Randoux C, et al. COVID-19 infection in kidney transplant recipients: disease incidence and clinical outcomes. J Am Soc Nephrol. 2020;31(10):2413\u201323.","journal-title":"J Am Soc Nephrol"},{"issue":"4","key":"1713_CR12","doi-asserted-by":"publisher","first-page":"51","DOI":"10.5500\/wjt.v2.i4.51","volume":"2","author":"HV Kalluri","year":"2012","unstructured":"Kalluri HV, Hardinger KL. Current state of renal transplant immunosuppression: Present and future. World J Transplant. 2012;2(4):51.","journal-title":"World J Transplant"},{"issue":"12","key":"1713_CR13","doi-asserted-by":"publisher","first-page":"2083","DOI":"10.1093\/ndt\/gfaa271","volume":"35","author":"S Ozturk","year":"2020","unstructured":"Ozturk S, Turgutalp K, Arici M, et al. Mortality analysis of COVID-19 infection in chronic kidney disease, haemodialysis and renal transplant patients compared with patients without kidney disease: a nationwide analysis from Turkey. Nephrol Dial Transplant. 2020;35(12):2083\u201395.","journal-title":"Nephrol Dial Transplant"},{"key":"1713_CR14","doi-asserted-by":"crossref","unstructured":"Aziz F, Mandelbrot D, Singh T, et al. Early report on published outcomes in kidney transplant recipients compared to Nontransplant patients infected with coronavirus disease 2019. In: Transplantation Proceedings. Vol 52. Elsevier; 2020:2659\u20132662.","DOI":"10.1016\/j.transproceed.2020.07.002"},{"issue":"6","key":"1713_CR15","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1016\/j.eururo.2020.03.039","volume":"77","author":"L Zhu","year":"2020","unstructured":"Zhu L, Gong N, Liu B, et al. Coronavirus disease 2019 pneumonia in immunosuppressed renal transplant recipients: a summary of 10 confirmed cases in Wuhan China. Eur Urol. 2020;77(6):748\u201354.","journal-title":"Eur Urol"},{"key":"1713_CR16","doi-asserted-by":"crossref","unstructured":"Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH. Essentials for radiologists on COVID-19: an update\u2014radiology scientific expert panel. Published online 2020.","DOI":"10.1148\/radiol.2020200527"},{"key":"1713_CR17","doi-asserted-by":"crossref","unstructured":"Yang R, Li X, Liu H, et al. Chest CT severity score: an imaging tool for assessing severe COVID-19. Radiol Cardiothorac Imaging. 2020;2(2):e200047.","DOI":"10.1148\/ryct.2020200047"},{"issue":"1","key":"1713_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/kisup.2012.1","volume":"2","author":"KAKI Workgroup","year":"2012","unstructured":"Workgroup KAKI. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2(1):1\u2013138.","journal-title":"Kidney Int Suppl"},{"issue":"2","key":"1713_CR19","doi-asserted-by":"publisher","first-page":"E32","DOI":"10.1148\/radiol.2020200642","volume":"296","author":"T Ai","year":"2020","unstructured":"Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing for coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020;296(2):E32\u201340.","journal-title":"Radiology"},{"key":"1713_CR20","volume-title":"Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia","author":"F Pan","year":"2020","unstructured":"Pan F, Ye T, Sun P, et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology: Published online; 2020."},{"issue":"1","key":"1713_CR21","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1097\/TP.0000000000003480","volume":"105","author":"I Benotmane","year":"2021","unstructured":"Benotmane I, Perrin P, Vargas GG, et al. Biomarkers of cytokine release syndrome predict disease severity and mortality from COVID-19 in kidney transplant recipients. Transplantation. 2021;105(1):158\u201369.","journal-title":"Transplantation"},{"key":"1713_CR22","volume-title":"COVID-19 in immunocompromised patients: a systematic review of cancer, hematopoietic cell and solid organ transplant patients","author":"JA Belsky","year":"2021","unstructured":"Belsky JA, Tullius BP, Lamb MG, Sayegh R, Stanek JR, Auletta JJ. COVID-19 in immunocompromised patients: a systematic review of cancer, hematopoietic cell and solid organ transplant patients. J Infect: Published online; 2021."},{"key":"1713_CR23","doi-asserted-by":"crossref","unstructured":"Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: a review. Clin Immunol. Published online 2020:108427.","DOI":"10.1016\/j.clim.2020.108427"},{"issue":"6","key":"1713_CR24","doi-asserted-by":"publisher","first-page":"1549","DOI":"10.1016\/j.kint.2020.08.005","volume":"98","author":"S Caillard","year":"2020","unstructured":"Caillard S, Anglicheau D, Matignon M, et al. An initial report from the French SOT COVID Registry suggests high mortality due to Covid-19 in recipients of kidney transplants. Kidney Int. 2020;98(6):1549\u201358.","journal-title":"Kidney Int"},{"key":"1713_CR25","doi-asserted-by":"crossref","unstructured":"Chen TY, Farghaly S, Cham S, et al. COVID\u201019 pneumonia in kidney transplant recipients: focus on immunosuppression management. Transpl Infect Dis. 2020;22(5):e13378.","DOI":"10.1111\/tid.13378"},{"issue":"2","key":"1713_CR26","doi-asserted-by":"publisher","first-page":"71","DOI":"10.3390\/transplantology1020007","volume":"1","author":"R Hage","year":"2020","unstructured":"Hage R, Steinack C, Gautschi F, Schuurmans MM. Transplant Drugs against SARS, MERS and COVID-19. Transplantology. 2020;1(2):71\u201384.","journal-title":"Transplantology"},{"key":"1713_CR27","volume-title":"Association between chronic use of immunosuppresive drugs and clinical outcomes from coronavirus disease 2019 (covid-19) hospitalization: a retrospective cohort study in a large us health system","author":"KM Andersen","year":"2021","unstructured":"Andersen KM, Mehta HB, Palamuttam N, et al. Association between chronic use of immunosuppresive drugs and clinical outcomes from coronavirus disease 2019 (covid-19) hospitalization: a retrospective cohort study in a large us health system. Clin Infect Dis: Published online; 2021."},{"key":"1713_CR28","unstructured":"Siemieniuk RA, Bartoszko JJ, Ge L, et al. Drug treatments for covid-19: living systematic review and network meta-analysis. Bmj. 2020;370."},{"key":"1713_CR29","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001282","volume-title":"A trial of lopinavir\u2013ritonavir in adults hospitalized with severe Covid-19","author":"B Cao","year":"2020","unstructured":"Cao B, Wang Y, Wen D, et al. A trial of lopinavir\u2013ritonavir in adults hospitalized with severe Covid-19. N Engl J Med: Published online; 2020."},{"issue":"6","key":"1713_CR30","doi-asserted-by":"publisher","first-page":"352","DOI":"10.14740\/jocmr4200","volume":"12","author":"S Adapa","year":"2020","unstructured":"Adapa S, Chenna A, Balla M, et al. COVID-19 pandemic causing acute kidney injury and impact on patients with chronic kidney disease and renal transplantation. J Clin Med Res. 2020;12(6):352.","journal-title":"J Clin Med Res"},{"key":"1713_CR31","volume-title":"The effect of prior angiotensin-converting enzyme inhibitor and angiotensin receptor blocker treatment on Coronavirus Disease 2019 (COVID-19) susceptibility and outcome: a systematic review and meta-analysis","author":"J Xu","year":"2020","unstructured":"Xu J, Teng Y, Shang L, et al. The effect of prior angiotensin-converting enzyme inhibitor and angiotensin receptor blocker treatment on Coronavirus Disease 2019 (COVID-19) susceptibility and outcome: a systematic review and meta-analysis. Clin Infect Dis: Published online; 2020."},{"issue":"1","key":"1713_CR32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-019-56847-4","volume":"10","author":"WYT Tan","year":"2020","unstructured":"Tan WYT, Young BE, Lye DC, Chew DEK, Dalan R. Statin use is associated with lower disease severity in COVID-19 infection. Sci Rep. 2020;10(1):1\u20137.","journal-title":"Sci Rep"},{"key":"1713_CR33","doi-asserted-by":"crossref","unstructured":"Fishman JA, Grossi PA. Novel Coronavirus\u201019 (COVID\u201019) in the immunocompromised transplant recipient:# Flatteningthecurve. Published online 2020.","DOI":"10.1111\/ajt.15890"},{"issue":"11","key":"1713_CR34","doi-asserted-by":"publisher","first-page":"3051","DOI":"10.1111\/ajt.16188","volume":"20","author":"ZS Chaudhry","year":"2020","unstructured":"Chaudhry ZS, Williams JD, Vahia A, et al. Clinical characteristics and outcomes of COVID-19 in solid organ transplant recipients: A cohort study. Am J Transplant. 2020;20(11):3051\u201360.","journal-title":"Am J Transplant"},{"issue":"5","key":"1713_CR35","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.2214\/AJR.20.22976","volume":"214","author":"W Zhao","year":"2020","unstructured":"Zhao W, Zhong Z, Xie X, Yu Q, Liu J. Relation between chest CT findings and clinical conditions of coronavirus disease (COVID-19) pneumonia: a multicenter study. Am J Roentgenol. 2020;214(5):1072\u20137.","journal-title":"Am J Roentgenol"},{"key":"1713_CR36","doi-asserted-by":"publisher","DOI":"10.1097\/RLI.0000000000000672","volume-title":"The clinical and chest CT features associated with severe and critical COVID-19 pneumonia","author":"K Li","year":"2020","unstructured":"Li K, Wu J, Wu F, et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Invest Radiol: Published online; 2020."}],"container-title":["Virology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12985-021-01713-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12985-021-01713-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12985-021-01713-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T12:45:53Z","timestamp":1638881153000},"score":1,"resource":{"primary":{"URL":"https:\/\/virologyj.biomedcentral.com\/articles\/10.1186\/s12985-021-01713-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1713"],"URL":"https:\/\/doi.org\/10.1186\/s12985-021-01713-x","relation":{},"ISSN":["1743-422X"],"issn-type":[{"value":"1743-422X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"19 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee of Guilan University of Medical Sciences (IR.GUMS.REC.1399.251).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from all participants initially or in the follow up visit. (Reviewer 2-comment 2).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors certify that no funding has been received for the conduct of this study and\/or preparation of this manuscript and no conflicts of interest exist.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"243"}}