Our experience in the management of renal transplant recipients in the COVID-19 pandemic

Abstract

169 patients with a functioning kidney transplant were observed. In 51 patients from 169 were diagnosed with COVID-19. The virus was verified by polymerase chain reaction in all patients and in 74% of cases immunoglobulins M and G were detected by immunological blood tests. Patients who underwent COVID-19 were divided into the following groups: Group 1 – kidney transplant recipients who recovered after COVID-19 (n=44); Group 2 – kidney transplant recipients who died (n=7). Lymphopenia, which was directly proportional to the severity of the disease, was observed in Group 2 patients. The serum C-reactive protein content of Group 2 patients did not differ significantly from that of Group 1. In Group 2 patients, the D-dimer content was significantly higher than that of Group 1. When we analyzed the percentage of lung lesions of the examined patients, it was found that in patients of Group 2 this figure was 68.0 [63.5; 75.0], which was probably higher than that of Group 1 patients (p<0.05). Kidney transplant dysfunction was observed in 16 recipients (31%) during the follow-up period of patients with COVID-19. Complications observed during the disease and arising from the treatment of patients accounted for 15.2%, of which thrombosis of various localizations – 1.5%, myocardial damage – 2.5%, bleeding – 3.4%. The mortality rate of kidney transplant recipients was 13.7%. The main cause of death was acute respiratory syndrome in combination with sepsis (in 8.1% of patients), pulmonary embolism (in 3.2%), and acute cerebrovascular accident (in 2.4%). According to our studies, the risk factors for an unfavorable outcome of COVID-19 are comorbid syndrome, the severity of lung damage, hyperalbuminuria, an increase in C-reactive protein, D-dimer, platelets and lymphopenia. Keywords: chronic kidney disease, kidney transplant, COVID-19.