Background: Pediatric kidney transplant (PKT) recipients are vulnerable to severe COVID-19. Limited data exist on the clinical characteristics and impact of COVID-19 in PKT recipients in China. This study assessed the one-year longitudinal outcomes in PKT recipients who contracted COVID-19, particularly Omicron subvariants.
Methods: We prospectively followed 299 PKT recipients who underwent at least one COVID-19 test before March 15, 2023, at a high-performing organ transplant center. COVID-19 severity was determined using NIH criteria. Renal allograft function was monitored at baseline, 0, 3, 6, and 9 months post-infection.
Results: Among the cohort, 139 (46.5%) PKT recipients were diagnosed with COVID-19 at a median of 2.2 (IQR 1.3-3.7) years post-transplant, with a mean age of 13.5±4.6 years at diagnosis. Only 7 (5%) patients were asymptomatic, while 5 (3.6%) and 3 (2.2%) patients experienced moderate and severe infections, respectively; no critical cases were reported. Among symptomatic patients, fever (84.1%), muscle pain (46.2%), and sore throat (38.6%) were the most common symptoms observed. Of the total, 23 patients received outpatient care, 16 received non-ICU inpatient care, and none required ICU admission. Notably, no respiratory failure, graft loss, or patient death attributed to COVID-19 infection was observed. In patients with moderate/severe infection, temporary impairment in allograft function was detected (72.1±28.3 vs 56.4±26.1 mL/min/1.73m², P = 0.026), although allograft function returned to normal within one year post-infection.
Conclusions: Even after removing COVID-19 restrictions, PKT recipients demonstrated favorable outcomes with appropriate management and support. Further research is necessary to comprehend the long-term impact of COVID-19 on PKT recipients and optimize their care.