Villanego, FlorentinoMazuecos, AuxiliadoraPerez-Flores, Isabel MMoreso, FrancescAndres, AmadoJimenez-Martinn, CarlosMolina, MariaCanal, CristinaSanchez-Camara, Luis AZarraga, SofíaRuiz-Fuentes, Maria Del CarmenAladren, Maria JoseMelilli, EdoardoLopez, VeronicaSanchez-Alvarez, EmilioCrespo, MartaPascual, Julio2023-02-092023-02-092021-03-18Villanego F, Mazuecos A, Pérez-Flores IM, Moreso F, Andrés A, Jiménez-Martín C, et al. Predictors of severe COVID-19 in kidney transplant recipients in the different epidemic waves: Analysis of the Spanish Registry. Am J Transplant. 2021 Jul;21(7):2573-2582http://hdl.handle.net/10668/17389SARS-CoV-2 infection has produced high mortality in kidney transplant (KT) recipients, especially in the elderly. Until December 2020, 1011 KT with COVID-19 have been prospectively included in the Spanish Registry and followed until recovery or death. In multivariable analysis, age, pneumonia, and KT performed ≤6 months before COVID-19 were predictors of death, whereas gastrointestinal symptoms were protective. Survival analysis showed significant increasing mortality risk in four subgroups according to recipient age and time after KT (age 6 months, age 6 and age ≥65 and time ≤6): mortality rates were, respectively, 11.3%, 24.5%, 35.4%, and 54.5% (p < .001). Patients were significantly younger, presented less pneumonia, and received less frequently specific anti- COVID- 19 treatment in the second wave (July– December) than in the first one (March– June). Overall mortality was lower in the second wave (15.1 vs. 27.4%, p < .001) but similar in critical patients (66.7% vs. 58.1%, p = .29). The interaction between age and time post- KT should be considered when selecting recipients for transplantation in the COVID- 19 pandemic. Advanced age and a recent KT should foster strict protective measures, including vaccination.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Clinical research/practiceInfection and infectious agents - viralKidney transplantation/nephrologyPatient survivalAgedCOVID-19HumansInfantKidney TransplantationPandemicsRegistriesSARS-CoV-2Transplant Recipientsresearch article33756067open accessMortalidadNeumoníaPandemiasVacunaciónAnálisis de supervivencia10.1111/ajt.165791600-6143PMC8250925https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8250925https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8250925/pdf