Abstract

Abstract Background and Aims Novel coronavirus 19 (coronavirus disease-19 [COVID-19]) disproportionately affects patients with various kidney diseases. Patients with kidney transplant are at higher risk of complications of COVID-19 infection. Our aim of this analysis was to study the clinical profile and outcome of COVID-19 infections in KTRs from Kashmir. Method Here we present a cohort study of 122 KTRs with polymerase chain reaction-confirmed COVID-19 positivity from March 31, 2020 to October 31, 2022. We detailed demographics, immunosuppression regimen, clinical profile, Covid 19 vaccination status, treatment given, and outcomes (acute kidney injury, graft failure and death) of our study population. Results Median age of the patients was 41 years and median age of disease was 2.9 years after transplant. Most common comorbidities included hypertension (65.6%) and diabetes (35.3%); presenting symptoms at the time of COVID-19 included fever (82.7%) and breathlessness (66.4%). Covid-19 vaccination was given to 81 patients (66.4%) with two doses in 26 patients and 55 patients received one dose. Clinical severity ranged from asymptomatic (4.1%), mild (36.1%), and moderate (28.7%), to severe (31.1%). Acute kidney injury developed in 46.7% of patients and mortality in 21 patients. Risk factors for mortality included higher age, severe disease, allograft dysfunction before COVID-19 infection, Obesity, acute kidney injury, absence of covid-19 vaccination (Table 1). At 3 months of follow-up, loss of graft function was seen in 19 patients of survivors. Conclusion Mortality rates in COVID-19-positive KTR appear to be higher than those in nonimmunosuppressed patients. Risk factors for mortality included higher age, severe disease, allograft dysfunction before COVID-19 infection, Obesity, acute kidney injury, absence of covid-19 vaccination.

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