COVID-19 in kidney transplant recipients: A experience in Colombia
PDF (Español)
XML-JATS (Español)

Keywords

COVID-19
dialysis
kidney
mortality
transplantation
SARS-CoV-2

How to Cite

1.
Duran CE, Estacio M, Mesa L, Schweinberg J, Posada JG, Espinosa D, Manzi E, Lozano F, Castro A. COVID-19 in kidney transplant recipients: A experience in Colombia. Rev. Colomb. Nefrol. [Internet]. 2022 Dec. 3 [cited 2024 Jul. 18];9(3). Available from: https://revistanefrologia.org/index.php/rcn/article/view/610

Abstract

Background: Patients with kidney transplants seem to be at particularly high risk for severe COVID19 disease due to their impaired immune responses and comorbidities.

Purpose: This study aims to describe kidney transplant patients’ clinical characteristics and outcomes with SARSCOV-2 infection in a fourth-level hospital in Cali, Colombia.

Methodology: We performed an observational study of kidney transplant recipients with SARS-CoV2 infection admitted at Fundación Valle del Lili from June to December 2020. To be eligible for this study, patients have symptoms compatible, a positive RT-PCR and inpatient management. Asymptomatic patients were excluded.

Results: We enrolled a total of 50 patients. 64% were male, and the median age was 53.5 years (range 46-60). The comorbidities were 36 (70%) hypertension, 16 (32%) diabetes mellitus, 5 (10%) obesity. The most common immunosuppressive regimen was tacrolimus, mycophenolate and prednisone. The median time from symptoms onset to the positive RT-PCR was 7 days. The most common initial symptom was fever (64%), and fatigue (58%), cough (44%) and dyspnea (36%). Baseline levels of CRP was 6.43 mg/dL (3.25-11.22). The median lymphocyte count was 785 mm3/uL (550-1230). Baseline D-Dimer was 0.767 ug/ml (0.484-1153.5), ferritin median level was 1011ng/ml (670-2145). Six of the patients died (12%), 4/6 were by sepsis-related multi-organ failure and 2/6 were by ARDS.

Conclusions: Major complications such as acute kidney injury, acute respiratory distress syndrome and mortality related to COVID-19 infection observed in our study are lower than those reported in other countries.

https://doi.org/10.22265/acnef.9.3.610
PDF (Español)
XML-JATS (Español)

References

Khan M, Adil SF, Alkhathlan HZ, Tahir M, Saif S, Khan M, et al. COVID-19: A Global Challenge with Old History, Epidemiology and Progress So Far. Molecules. 2020;26(1). https://doi.org/10.3390/molecules26010039

Jordan RE, Adab P, Cheng KK. Covid-19: risk factors for severe disease and death. BMJ. 2020;368. https://doi.org/10.1136/bmj.m1198

Mahalingasivam V, Craik A, Tomlinson LA, Ge L, Hou L, Wang Q, et al. A Systematic Review of COVID-19 and Kidney Transplantation. Kidney Int Reports. 2021;6(1):24. https://doi.org/10.1016/j.ekir.2020.10.023

Sharma V, Shaw A, Lowe M, Summers A, van Dellen D, Augustine T. The impact of the COVID-19 pandemic on renal transplantation in the UK. Clin Med (Northfield Il). 2020;20(4):e82. https://doi.org/10.7861/clinmed.2020-0183

Khairallah P, Aggarwal N, Awan AA, Vangala C, Airy M, Pan J, et al. The impact of COVID?19 on kidney transplantation and the kidney transplant recipient - One year into the pandemic. Transpl Int. 2021;34(4):612-21. https://doi.org/10.1111/tri.13840

Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4). https://doi.org/10.1159/000339789

Instituto Nacional de Salud. Modelos de datos COVID-19 [Internet]. INS, 2021 [accedido 2021 nov. 20]. Disponible en: https://www.ins.gov.co/Direcciones/ONS/modelos-covid-19

Arias-Murillo YR, Benavides CA, Salinas MA, Osorio-Arango K, Plazas-Sierra C, Cortés JA. SARS-CoV2/COVID-19 Infection in Transplant Recipients and in Patients on the Organ Transplant Waiting List in Colombia. Transplant Proc. 2021;53(4):1237-44. https://doi.org/10.1016/j.transproceed.2020.12.003

Richardson S, Hirsch JS, Narasimhan M, Crawford J, McGinn T, Davidson K, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323(20):2052-9. https://doi.org/10.1001/jama.2020.6775

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet (Londres, Inglaterra). 2020;395(10229):1054-62. https://doi.org/10.1016/S0140-6736(20)30566-3

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (Londres, Inglaterra). 2020;395(10223):497-506. https://doi.org/10.1016/S0140-6736(20)30183-5

Kute VB, Bhalla AK, Guleria S, Deepak R, Madan B, Ashay S, et al. Clinical Profile and Outcome of COVID-19 in 250 Kidney Transplant Recipients: A Multicenter Cohort Study From India. Transplantation. 2021;105(4):851-60. https://doi.org/10.1097/TP.0000000000003593

Cravedi P, Mothi SS, Azzi Y, Haverly M, Farouk S, Pérez M, et al. COVID?19 and kidney transplantation: Results from the TANGO International Transplant Consortium. Am J Transplant. 2020;20(11):3140-8. https://doi.org/10.1111/ajt.16185

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. https://doi.org/10.1001/jama.2020.1585

Toapanta N, Torres IB, Sellarés J, Chamoun B, Serón D, Moreso F. Kidney transplantation and COVID-19 renal and patient prognosis. Clin Kidney J. 2021;14(supl. 1):i21. https://doi.org/10.1093/ckj/sfab030

Matthay MA, Arabi YM, Siegel ER, Ware L, Bos L, Sinha P, et al. Phenotypes and personalized medicine in the acute respiratory distress syndrome. Intensive Care Med. 2020;46(12):2136-52. https://doi.org/10.1007/s00134-020-06296-9

Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):934-43. https://doi.org/10.1001/jamainternmed.2020.0994

Legrand M, Bell S, Forni L, Joannidis M, Koyner J, Liu K, et al. Pathophysiology of COVID-19-associated acute kidney injury. Nat Rev Nephrol. 2021;17(11):751-64. https://doi.org/10.1038/s41581-021-00452-0

Hirsch JS, Ng JH, Ross DW, Sharma P, Shah H, Barnett R, et al. Acute kidney injury in patients hospitalized with COVID-19. Kidney Int. 2020;98(1):209-18. https://doi.org/10.1016/j.kint.2020.05.006

Lin L, Wang X, Ren J, Sun Y, Yu R, Li K, et al. Risk factors and prognosis for COVID-19-induced acute kidney injury: a meta-analysis. BMJ Open. 2020;10(11). https://doi.org/10.1136/bmjopen-2020-042573

Pezeshgi A, Mubarak M, Djamali A, Mostafavi L, Maghadam-Kia S, Alimohammadi N, et al. COVID-19-associated glomerulopathy and high-risk APOL1 genotype; Basis for a two-hit mechanism of injury? A narrative review on recent findings. J Nephropathol. 2020;10(2):e11. https://doi.org/10.34172/jnp.2021.11

Friedman DJ. COVID-19 and APOL1: Understanding Disease Mechanisms through Clinical Observation. J Am Soc Nephrol. 2021;32(1):1-2. https://doi.org/10.1681/ASN.2020111629

Pampols PA, Trujillo H, Melilli E, Urban B, Sandino J, Favá A, et al. Immunosuppression minimization in kidney transplant recipients hospitalized for COVID-19 GRAPHICAL ABSTRACT. Clin Kidney J. 2021;14(4):1229-35. https://doi.org/10.1093/ckj/sfab025

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Dimensions


PlumX


Downloads

Download data is not yet available.