COVID-19 in kidney transplant recipients; a DALMATIAN single-center experience

Ther Apher Dial. 2023 Feb;27(1):107-116. doi: 10.1111/1744-9987.13894. Epub 2022 Jun 19.

Abstract

Introduction: We aimed to explore COVID-19 severity, complications, and outcome predictors in the Dalmatian population of kidney transplant recipients (KTRs).

Methods: KTRs confirmed with acute COVID-19 infection until May 2021 were included and followed up for 6 months.

Results: Out of 50 KTRs average aged 63 years, 36 (72%) were men. Nine (18%) KTRs had no pulmonary infiltration, and twenty-nine (58%) did not require oxygen supplementation. Bilateral pulmonary infiltrates had 29 (58%) while high-flow nasal cannula or mechanical ventilation required 8 (16%) KTRs. The mortality rate was 16%. Acute kidney injury developed in 18 (36%), and acute renal replacement therapy required 2 (4%) KTRs. Nine (18%) KTRs were subsequently rehospitalized. Chronic COVID-19 syndrome reported 23 (58%) KTRs.

Conclusions: D-dimers were found to be the key prognostic factor of clinical complications, emphasizing the importance of underlying thrombotic microangiopathy. Optimal immunosuppressant adjusting in KTRs with acute COVID-19 infection remains to be clarified.

Keywords: COVID-19 infection; kidney transplantation; long-COVID-19; rehospitalization.

MeSH terms

  • Acute Kidney Injury* / epidemiology
  • COVID-19* / epidemiology
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Kidney Transplantation*
  • Male
  • Renal Replacement Therapy

Substances

  • Immunosuppressive Agents