Clinical Characteristics, Biochemical Markers, and Outcomes of Postrenal Transplant Patients with Coronavirus Diseases 2019: A Single-Center Experience.

Abstract

The transplant recipient stays in an immunocompromised state for a definite period of time to reduce the risk of rejection and hence has more susceptibility to acquiring infections given the current coronavirus disease 2019 (COVID-19) pandemic. This study is aimed to document the clinical features of COVID-19 and biochemical markers in postrenal transplant population. This study was conducted at the renal transplant department of Dow University Hospital, Karachi, for a duration of one month and was designed as a retrospective observational study. It included all postrenal transplant patients who were assessed for COVID-19 through either nasopharyngeal or oropharyngeal swab for polymerase chain reaction. A total of 159 individuals were assessed and 28.30% were found COVID-19 positive. The mortality rate was 8.88% out of the 45 infected patients. The mean age of COVID-19-infected patients was 34.75 ± 11.50 years with 60% of males and 40% of females. The most frequent comorbidities were hypertension and diabetes mellitus. The current use of immunosuppressants either tacrolimus or cyclosporine was independently associated with acquiring COVID-19 (P <0.001) with an adjusted odds ratio [aOR] [95% confidence interval (CI)] of 1.703 (0.842-2.683) while diabetes was not associated with acquiring COVID-19 (P = 0.001) with an aOR (95% CI) of 0.513 (0.240-1.095). The frequent symptoms were fever, dry cough, sore throat, dyspnea, and arthralgia/myalgia. Diabetes mellitus was associated with early onset (P = 0.031), while the use of mycophenolate mofetil (P = 0.008) and corticosteroids (P = 0.002) was associated with delayed onset of bilateral pulmonary infiltrates. Our study brings the most recent data on postrenal transplant COVID-19 infection.