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Kidney Transplant Recipients Infected With Coronavirus Disease 2019: Retrospective Qatar Experience

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submitted on 2023-10-29, 11:51 and posted on 2023-10-29, 12:14 authored by Mohamad M. Alkadi, Hassan A. Al-Malki, Muhammad Asim, Omar M. Fituri, Ahmed F. Hamdi, Rihab I. Elidrisi, Ramzi Abdul Rahiman, Mostafa F. Elshirbeny, Muftah A. Othman, Awais Nauman, Adel Ashour, Tarek A. Ghonimi, Hiba Tohid, Mona E. Jarman, Abdullah Hamad, Mohamed B. Elshazly, Essa Abuhelaiqa

Background

This study aimed to evaluate the incidence of coronavirus disease 2019 (COVID-19) infection on kidney transplant, mortality, and risk factors associated with infection acquisition and severe illness in kidney transplant recipients with COVID-19.

Methods

Of 693 kidney transplant recipients who reported to our center, 249 were tested for COVID-19 by throat and nasal swab reverse transcription polymerase chain reaction. Of these, 43 recipients tested positive and 206 recipients tested negative. Among the 43 positive recipients, 9 were treated within an isolation facility, 25 were admitted to the hospital, and 9 were admitted to the intensive care unit (ICU). Risk factors associated with positive results and ICU admission were evaluated.

Results

COVID-19 was found in 6% of transplant recipients. Asian ethnicity (p = .003), history of hypertensive nephropathy (p = .01), AB blood group (P = .04), and higher tacrolimus trough levels (P = .007) were more frequent in the COVID-19 positive than in the COVID-19 negative group. ICU admission was more frequent in recipients presenting with fever, shortness of breath, and acute allograft dysfunction. Renal replacement therapy was required in 3 (7%) of 43 recipients, and mortality was reported in 1 (2.3%) recipient. Acute allograft dysfunction was an independent risk factor for severe COVID-19 (odds ratio, 93.7; 95% confidence interval, 2.37-3710.94; P = .02).

Conclusions

Higher tacrolimus targets may be associated with COVID-19 development. Acute kidney injury during the COVID-19 course may be a sign of severe disease. Prognostication of COVID-19 severity in kidney transplant recipients is crucial for early recognition of critical illness and may ensure early intervention.

Other Information

Published in: Transplantation Proceedings
License: http://creativecommons.org/licenses/by/4.0/
See article on publisher's website: https://dx.doi.org/10.1016/j.transproceed.2021.06.001

Funding

Open Access funding provided by the Qatar National Library

History

Language

  • English

Publisher

Elsevier

Publication Year

  • 2021

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License

Institution affiliated with

  • Hamad Medical Corporation
  • Hamad General Hospital - HMC
  • Weill Cornell Medicine - Qatar

Geographic coverage

Qatar