Publication date: Feb 11, 2025

The long-term cardiovascular consequences of COVID-19 in organ recipients have been insufficiently studied. The aim of our study was to evaluate the association between COVID-19 and microvascular abnormalities in kidney transplant recipients 8 weeks after SARS-CoV-2 infection. Patients and methods: The study population consisted of 54 kidney transplant recipients, and was divided into two subgroups: patients with a history of COVID-19 (n = 35) and patients without a history of COVID-19 (n = 21). We assessed both the structure and function of microcirculation. The study group was aged 47. 6 (12. 7) years and included 54% of women. Patients with and without a history of COVID-19 did not differ in baseline characteristics. Compared to patients without a history of COVID-19, subjects after SARS-CoV-2 infection had substantially lower values of ischemic response: IRmax; 7. 0 (5. 0-8. 7) vs. 9. 6 (8. 8-11. 5), P = 0. 04; IR index 3. 1 (2. 3-4. 2) vs 7. 2 (5. 2-8. 2), P = 0. 01), with the IR index further confirmed in a multivariable analysis. Logistic regression analysis showed that estimated glomerular filtration rate was linked to microvascular functional decline, expressed by a poorer normoxia oscillatory index (odds ratio 0. 95, CI 0. 90-0. 99, P = 0. 047). C-reactive protein was associated with arterioles’ wall thickness (R = 0. 42, P = 0. 02) and wall-to-lumen ratio (R = 0. 48, P = 0. 01). We documented that microvascular dysfunction was associated with SARS-CoV-2 infection and is detectable 8 weeks after the acute phase in kidney transplant recipients.

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