Clinical course of COVID-19 disease in immunosuppressed renal transplant patients

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Background/aim: We aimed to identify clinical settings of renal transplant patients with COVID-19.

Materials and methods: In this retrospective study, we included kidney transplant inpatients with laboratory confirmed COVID-19 who had been discharged or had died by October 1st, 2020. Characteristics of the patients, including basal and last outpatient biochemical parameters were recorded. Discontinuation or dosage reduction of immunosuppressives and other treatment information was documented.

Results: Twenty patients were included in this study, of whom 18 were discharged and 2 died in hospital. The mean duration of hospitalization and follow-up were 9.7 ± 6.4 days and 4.5 ± 2.0 months, respectively. Fourteen patients (70%) were male and mean age was 48.0 ± 10.3 years. At admission, all had immunosuppression withdrawn and were started on methylprednisolone 16 mg/ day (50%) or dexamethasone (50%). Tacrolimus/m-TOR inhibitors were reduced by 50% and all antimetabolites were discontinued. Hemodialysis was needed for 10% of patients. Acute kidney injury was detected in 25% of the patients. With respect to hospitalization time and complications, there was no significant difference between patients who used dexamethasone and those who did not (P > 0.05). The discontinued immunosuppressives were resumed within 2 to 4 weeks after discharge according to the severity of disease. No rehospitalization or acute rejection was detected during the follow-up of the patients.

Conclusion: Renal transplant patients are considered a high risk group for COVID-19. It can be said that discontinuation or reducing dosages of immunosuppressives may be effective and safe in kidney transplant patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:51

Enthalten in:

Turkish journal of medical sciences - 51(2021), 2 vom: 30. Apr., Seite 428-434

Sprache:

Englisch

Beteiligte Personen:

Dheir, Hamad [VerfasserIn]
Sipahi, Savaş [VerfasserIn]
Yaylacı, Selçuk [VerfasserIn]
Çetin, Esma Seda [VerfasserIn]
Genç, Ahmed Bilal [VerfasserIn]
Fırat, Necattin [VerfasserIn]
Köroğlu, Mehmet [VerfasserIn]
Muratdağı, Gürkan [VerfasserIn]
Tomak, Yakup [VerfasserIn]
Özmen, Kezban [VerfasserIn]
Ateş, Ömer Faruk [VerfasserIn]
Karabay, Oğuz [VerfasserIn]

Links:

Volltext

Themen:

7S5I7G3JQL
9HW64Q8G6G
Acute rejection
COVID-19
Dexamethasone
Everolimus
Glucocorticoids
HU9DX48N0T
Immunosuppression
Immunosuppressive Agents
Journal Article
Kidney transplantation
Methylprednisolone
Mortality
Mycophenolic Acid
SARS-CoV-2
Tacrolimus
WM0HAQ4WNM
X4W7ZR7023

Anmerkungen:

Date Completed 07.05.2021

Date Revised 25.06.2021

published: Electronic

Citation Status MEDLINE

doi:

10.3906/sag-2007-260

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM317528645