POS-789 DEATH IN KIDNEY TRANSPLANT RECIPIENTS WITH COVID-19 EXPERIENCE OF NEPHROLOGY DEPARTMENT OF SAHLOUL HOSPITAL

Abstract

Infections related to the novel coronavirus SARS-CoV-2 had affected people from many countries and caused deaths worldwide.The COVID-19 pandemic has brought unprecedented challenges to the transplant community. The reduction in transplantation volume during this time is partly due to concerns over potentially increased susceptibility and worsened outcomes of COVID-19 in immunosuppressed recipients. Hospitalized kidney transplant recipients with COVID-19 are at a high risk of death in early reports. COVID-19 infections were diagnosed in 47 patients of our cohort of 300 kidney transplant recipients between March 2020 and August 2021; they were screened for baseline and transplant characteristics, functional parameters, comorbidities, and immunosuppressive therapies. A standard strategy of immunosuppression minimization was applied: discontinue the antimetabolite drug and reduce trough levels of calcineurin or mammalian target of rapamycin inhibitors. Among 300 kideny transplant recipients performed between 2008 and 2020 in our department, 47 patients (15.6%) have had an infection with the new Coronavirus (COVID-19). Their mean age was 41.57±16 years; 31 men and 16 woman. For these infected patients, the mean time of years of transplantation was 6.5 years. Comorbidities such as diabetes were noted in 8patients, arterial hypertension in 21 patients. Most common initial symptoms included fever, cough, or dyspnea. 22 patients (46.8%) required hospitalization because of hypoxia requiring oxygen therapy. Of those patients, 11 had computed tomography of the chest at admission which showed severe involvement. 10patients are reported to have been hospitalized in intensive care for high oxygen requirements following covid pneumonia.Immunosuppression reduction was initiated for all patients. All patients received cortticoistoides and Enoxaparin. The mortality rate following infection by covid 19 is 17.02%. All patients who died had severe pulmonary involvement. The clinical presentation of COVID-19 infection was similar to that reported in the general population. A standard strategy of immunosuppression minimization and treatment was applied. Patients with kidney transplants display a high risk of mortality. This work highlights the mortality excess in transplant recipients but medium-and longer-term outcomes remain uncertain and merit careful investigation.