Abstract
BackgroundWe aimed to present the demographic characteristics, clinical presentation, and outcomes of our multicenter cohort of adult KTx recipients with COVID-19.MethodsWe conducted a multicenter, retrospective study using data of patients hospitalized for COVID-19 collected from 34 centers in Turkey. Demographic characteristics, clinical findings, laboratory parameters (hemogram, CRP, AST, ALT, LDH, and ferritin) at admission and follow-up, and treatment strategies were reviewed. Predictors of poor clinical outcomes were analyzed. The primary outcomes were in-hospital mortality and the need for ICU admission. The secondary outcome was composite in-hospital mortality and/or ICU admission.ResultsOne hundred nine patients (male/female: 63/46, mean age: 48.4 ± 12.4 years) were included in the study. Acute kidney injury (AKI) developed in 46 (42.2%) patients, and 4 (3.7%) of the patients required renal replacement therapy (RRT). A total of 22 (20.2%) patients were admitted in the ICU, and 19 (17.4%) patients required invasive mechanical ventilation. 14 (12.8%) of the patients died. Patients who were admitted in the ICU were significantly older (age over 60 years) (38.1% vs 14.9%, p = 0.016). 23 (21.1%) patients reached to composite outcome and these patients were significantly older (age over 60 years) (39.1% vs. 13.9%; p = 0.004), and had lower serum albumin (3.4 g/dl [2.9–3.8] vs. 3.8 g/dl [3.5–4.1], p = 0.002), higher serum ferritin (679 μg/L [184–2260] vs. 331 μg/L [128–839], p = 0.048), and lower lymphocyte counts (700/μl [460–950] vs. 860 /μl [545–1385], p = 0.018). Multivariable analysis identified presence of ischemic heart disease and initial serum creatinine levels as independent risk factors for mortality, whereas age over 60 years and initial serum creatinine levels were independently associated with ICU admission. On analysis for predicting secondary outcome, age above 60 and initial lymphocyte count were found to be independent variables in multivariable analysis.ConclusionOver the age of 60, ischemic heart disease, lymphopenia, poor graft function were independent risk factors for severe COVID-19 in this patient group. Whereas presence of ischemic heart disease and poor graft function were independently associated with mortality.
Highlights
The novel coronavirus 2019 disease (COVID-19), which originated in the city of Wuhan, in Hubei province, China, infected more than 33 million people and caused nearly 1 million reported deaths worldwide
We aimed to present the clinical manifestations, course of the disease and outcomes of a large multicenter cohort of adult Kidney transplantation (KTx) recipients with COVID-19 in this study
Demographic and clinical characteristics A total of 109 KTx recipients hospitalized with COVID19 from 34 different centers were included in the study. 63 (57.8%) were male, and the mean age was 48.4 ± 12.4 (19.4% more than 60) years (Table 1)
Summary
The novel coronavirus 2019 disease (COVID-19), which originated in the city of Wuhan, in Hubei province, China, infected more than 33 million people and caused nearly 1 million reported deaths worldwide (https:// coronavirus.jhu.edu/map.html). The case fatality rates vary in different reports It ranged from 1 to 7.2% and reached 49% among patients with critical illnesses [3, 4]. The diagnosis and clinical course of the disease in solid organ transplant (SOT) recipients may differ from the general population due to chronic immunosuppression and coexisting conditions [6]. We aimed to present the clinical manifestations, course of the disease and outcomes of a large multicenter cohort of adult KTx recipients with COVID-19 in this study. We aimed to present the demographic characteristics, clinical presentation, and outcomes of our multicenter cohort of adult KTx recipients with COVID-19
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
