Yapay Zeka Hızlı Bakış & Çıkarımlar
AI InsightLarger prospective multicenter studies are warranted to validate the association and determine whether Hp genotype adds meaningful prognostic information beyond established clinical risk factors.
📌 3 Maddede Bu Makale
Abstract
Aims: Kidney transplant recipients (KTRs) are at increased risk of severe coronavirus disease 2019 (COVID-19), yet host factors contributing to interindividual variation in disease severity remain incompletely defined. Haptoglobin (Hp) is a genetically polymorphic plasma protein with antioxidant and immunomodulatory functions. We aimed to evaluate the association between Hp genotype and COVID-19 severity in KTRs, with particular focus on the Hp 2-2 genotype. Methods: This retrospective single-center cohort study included 229 adult KTRs in whom Hp genotyping had been completed before the COVID-19 pandemic. Sixty-two symptomatic recipients with reverse transcription-polymerase chain reaction (RT-PCR)-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection between March 2020 and November 2021 comprised the COVID-19 cohort. Severe or critical COVID-19 was defined as the primary clinical endpoint, while intensive care requirement, ventilatory support, hospitalization-related outcomes, and COVID-19-related mortality were evaluated as secondary outcomes. The three Hp genotypes were evaluated separately, with a secondary sensitivity analysis comparing Hp 2-2 with Hp1-containing genotypes (Hp 1-1/Hp 2-1). A parsimonious multivariable logistic regression model evaluated severe/critical COVID-19 after adjustment for age, diabetes mellitus, and baseline estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m². Results: Baseline characteristics were comparable across Hp genotype groups. In the three-genotype analysis, Hp 2-2 was associated with a more adverse clinical course, with significant differences in hospitalization duration, respiratory compromise, ventilatory support, intensive care unit admission, and overall COVID-19 severity. In the secondary Hp 2-2 versus Hp1-carrier analysis, Hp 2-2 was associated with severe/critical COVID-19 [odds ratio (OR) 7.88, 95% confidence interval (CI) 2.45-25.35; p<0.001] and COVID-19-related mortality (OR 3.88, 95% CI 1.14-13.17; p=0.036). After adjustment for age, diabetes mellitus, and baseline eGFR <60 ml/min/1.73 m², the association with severe/critical COVID-19 remained significant (adjusted OR 20.91, 95% CI 3.86-113.31; p<0.001). Conclusion: Hp 2-2 genotype was consistently associated with adverse COVID-19 outcomes in KTRs and remained strongly associated with severe/critical disease after multivariable adjustment. These findings support the prognostic relevance of Hp genotype in this high-risk population. Larger prospective multicenter studies are warranted to validate the association and determine whether Hp genotype adds meaningful prognostic information beyond established clinical risk factors.