{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:23:09Z","timestamp":1783686189041,"version":"3.55.0"},"reference-count":27,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National High-Level Hospital Clinical Research Funding","award":["2022CX10"],"award-info":[{"award-number":["2022CX10"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: Coronavirus disease 2019 (COVID-19) poses a significant threat to kidney transplant recipients (KTRs) due to chronic immunosuppression. While Azvudine has demonstrated antiviral efficacy, its long-term impact on allograft function in KTRs remains unknown. This single-arm retrospective study provides a comprehensive evaluation of the outcomes. Methods: This single-center, retrospective study consecutively enrolled 20 KTRs diagnosed with COVID-19 during the Omicron surge (December 2022\u2013January 2023), all treated with an Azvudine-centered regimen. Clinical data, treatment responses, and serial renal function parameters were analyzed. Long-term follow-up extended to a median of 39 months. Results: The median time to COVID-19 nucleic acid negativity was 13.22 days. Renal function improved significantly during treatment: estimated glomerular filtration rate increased by a mean of 27.29 mL\/min\/1.73 m2, and serum creatinine decreased by 57.72 \u00b5mol\/L (both p &lt; 0.01). Common complications included electrolyte imbalances and co-infections (50% of patients). Crucially, at a median follow-up of 39 months, 75% (15\/20) of patients maintained normal allograft function. No Azvudine-related adverse events or drug interactions with immunosuppressants were observed. Conclusions: While acknowledging the inherent limitations of a non-comparative design, this study provides preliminary evidence suggesting that an Azvudine-centered regimen may be associated with promising efficacy, a favorable safety profile without interference with immunosuppressive therapy, and\u2014most importantly\u2014durable renal allograft survival in KTRs with COVID-19. Our data suggest that this regimen could contribute to mitigating the long-term risk of allograft dysfunction, potentially bringing outcomes closer to the expected baseline for stable recipients. Coupled with its low risk of drug\u2013drug interactions, potential immunomodulatory benefits, and superior cost-effectiveness, Azvudine could be considered a valuable therapeutic option for this high-risk population in the post-pandemic era, although these findings warrant cautious interpretation. Controlled trials are ultimately needed to confirm these observations.<\/jats:p>","DOI":"10.3390\/jcm15145417","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:43:34Z","timestamp":1783683814000},"page":"5417","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Azvudine for COVID-19 in Kidney Transplant Recipients: A Real-World Observational Study of Long-Term Renal Outcomes"],"prefix":"10.3390","volume":"15","author":[{"given":"Xiaoyu","family":"Li","sequence":"first","affiliation":[{"name":"Department of Urology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China"},{"name":"Institute of Urology, Peking University, Beijing 100034, China"},{"name":"Beijing Key Laboratory of Precision Medicine and Innovative Translation for Urogenital Diseases, Beijing 100034, China"},{"name":"National Urological Cancer Center, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Urology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China"},{"name":"Institute of Urology, Peking University, Beijing 100034, China"},{"name":"Beijing Key Laboratory of Precision Medicine and Innovative Translation for Urogenital Diseases, Beijing 100034, China"},{"name":"National Urological Cancer Center, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyuan","family":"Leng","sequence":"additional","affiliation":[{"name":"Department of Urology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China"},{"name":"Institute of Urology, Peking University, Beijing 100034, China"},{"name":"Beijing Key Laboratory of Precision Medicine and Innovative Translation for Urogenital Diseases, Beijing 100034, China"},{"name":"National Urological Cancer Center, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shufang","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Urology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China"},{"name":"Institute of Urology, Peking University, Beijing 100034, China"},{"name":"Beijing Key Laboratory of Precision Medicine and Innovative Translation for Urogenital Diseases, Beijing 100034, China"},{"name":"National Urological Cancer Center, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenpeng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Urology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China"},{"name":"Institute of Urology, Peking University, Beijing 100034, China"},{"name":"Beijing Key Laboratory of Precision Medicine and Innovative Translation for Urogenital Diseases, Beijing 100034, China"},{"name":"National Urological Cancer Center, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China"},{"name":"Institute of Urology, Peking University, Beijing 100034, China"},{"name":"Beijing Key Laboratory of Precision Medicine and Innovative Translation for Urogenital Diseases, Beijing 100034, China"},{"name":"National Urological Cancer Center, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenke","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Urology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China"},{"name":"Institute of Urology, Peking University, Beijing 100034, China"},{"name":"Beijing Key Laboratory of Precision Medicine and Innovative Translation for Urogenital Diseases, Beijing 100034, China"},{"name":"National Urological Cancer Center, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China"},{"name":"Institute of Urology, Peking University, Beijing 100034, China"},{"name":"Beijing Key Laboratory of Precision Medicine and Innovative Translation for Urogenital Diseases, Beijing 100034, China"},{"name":"National Urological Cancer Center, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gengyan","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Urology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China"},{"name":"Institute of Urology, Peking University, Beijing 100034, China"},{"name":"Beijing Key Laboratory of Precision Medicine and Innovative Translation for Urogenital Diseases, Beijing 100034, China"},{"name":"National Urological Cancer Center, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Urology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China"},{"name":"Institute of Urology, Peking University, Beijing 100034, China"},{"name":"Beijing Key Laboratory of Precision Medicine and Innovative Translation for Urogenital Diseases, Beijing 100034, China"},{"name":"National Urological Cancer Center, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Urology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China"},{"name":"Institute of Urology, Peking University, Beijing 100034, China"},{"name":"Beijing Key Laboratory of Precision Medicine and Innovative Translation for Urogenital Diseases, Beijing 100034, China"},{"name":"National Urological Cancer Center, Beijing 100034, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1016\/j.cmi.2025.05.032","article-title":"Management of COVID-19 in immunocompromised patients: An European Society of Clinical Microbiology and Infectious Diseases consensus document","volume":"31","author":"Bartoletti","year":"2025","journal-title":"Clin. 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