DOI: 10.32322/jhsm.1957200 ISSN: 2636-8579

Association of haptoglobin genotype with COVID-19 severity in kidney transplant recipients: a retrospective cohort study

Zeynep Ural, Özant Helvacı, Berfu Korucu, Sevim Gönen, Ülver Derici
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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)

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