Prognosis and Risks for Renal Transplant Recipients During the COVID-19 Pandemic
Renal Transplant Recipients and COVID-19
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https://doi.org/10.5281/zenodo.10654141Keywords:
COVID-19, kidney transplant recipients, hemodialysis, prognosisAbstract
Background: We aim to compare potential factors that may affect the prognosis of kidney transplant recipients (KTRs) and hemodialysis patients (HDPs) with the diagnosis of COVID-19.
Method: This single-center retrospective study was conducted at the University of Health Science Diskapi Yildirim Beyazit Training and Research Hospital hospital. From March 1, 2021, to September 30, 2021, 110 individuals diagnosed with COVID-19 and ≥18 years old were included in our study. The study population comprised 29 kidney transplant recipients (KTRs) and 81 hemodialysis patients (HDPs). Data were collected from the hospital’s software and included patient descriptive features, laboratory test results, medication records, demographic information, comorbidities, and clinical outcomes of COVID-19 diagnosis, such as mortality and discharge rates.
Results: A total of 110 patients (29 KTRs, 81 HDPs) were evaluated. There was no significant difference in mortality rates observed between the groups (p=0.117). Coronary artery disease (CAD) was found associated with mortality in both KTRs and HDPs (p=0.001 and p=0.021, respectively). A logistic regression analysis model identified age above 55 years as a significant mortality-related factor in HDPs (p=0.039). Pro-brain natriuretic peptide (pro-BNP) and procalcitonin levels at admission, and increase in serum creatinine, neutrophil count, lactate dehydrogenase (LDH), d-dimer, procalcitonin and urea urea during hospitalization were associated with death in KTRs (p<0.05).
Conclusion: This study highlights comparable mortality rates in KTRs and HDPs hospitalized due to COVID-19. Kidney injury (increase in creatinine, urea), presence of CAD, proBNP, D-dimer, LDH), and inflammation (increase in neutrophil count, procalcitonin) could be a predictor of mortality in KTRS with COVID-19. Despite ongoing debates on immunosuppressive medications, our findings suggest a potential role in mitigating COVID-19 severity. Additionally, age > 55 years is a strong indicator of mortality in HDPs with COVID-19.
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