Is Early COVID-19 in Kidney Transplant Recipients Concerning Enough to Halt Transplantation? A Multicenter Comparative Analysis from India

Overview

Journal Transplant Proc

Specialty General Surgery

Date 2021 Sep 24

PMID 34556343

Citations 1

Authors

Hari Shankar Meshram

Vivek B Kute

Himanshu V Patel

Umapati Hegde

Pratik Das

Keshab Sil

Manisha Sahay

Sree Bhushan Raju

Arpita Ray Chaudhury

Vishwanath Siddini

Vivek Pathak

M M Bahadur

Urmila Anand

Amresh Krishna

Abi Abraham

Ansy H Patel

Vineet Mishra

Sanshriti Chauhan

Affiliations

Soon will be listed here.

Abstract

Background: Limited data exist on the incidence and outcome of early coronavirus disease 2019 (COVID-19) in kidney transplantation recipients (KTR).

Methods: A retrospective multicenter research study was conducted across 12 centers in India. We explored the symptomatology, demographic, laboratory findings, and outcome of COVID-19 within 30 days of transplantation. The outcome was compared with the overall KTR and waitlisted patients acquiring COVID-19.

Results: The incidence of early COVID-19 was 2.6% (n = 22) for the cumulative 838 renal transplants performed since nationwide lockdown in March 2020 until May 2021. Overall, 1049 KTR were diagnosed with COVID-19 and 2% of those had early COVID-19. The median age of the early COVID-19 cohort was 43 (31-46) years. COVID-19 severity ranged from asymptomatic (18.2%), mild (59.1%), moderate (9.1%), and severe (13.6%). Among clinical symptoms, dyspnea and anosmia were frequent, and in laboratory parameters, neutrophil lymphocyte ratio, high-sensitivity C-reactive protein, and D-dimer were higher in patients requiring oxygen. The mortality in early COVID-19 was not higher than overall KTR (4.5% vs 8.5%; P = 1). COVID-19 severity (23.9% vs 15.7%; P = .0001) and mortality (15.5% vs 8.5%; P = .001) among waitlisted patients (n = 1703) were higher compared with overall KTR.

Conclusions: We report higher burden of COVID-19 in waitlisted patients compared with KTR and a favorable outcome in early COVID-19 in KTR. Our report will help the transplant physicians in dealing with the ongoing dilemma of halting or resuming transplantation in the COVID-19 era.

Citing Articles

A Multicenter Cohort Study From India of ABO-Incompatible Kidney Transplantation in Post-COVID-19 Patients.

Kute V, Ray D, Dalal S, Hegde U, Godara S, Pathak V Transplant Proc. 2022; 54(10):2652-2657.

PMID: 35995711 PMC: 9300716. DOI: 10.1016/j.transproceed.2022.07.002.

References

Chadban S, Ahn C, Axelrod D, Foster B, Kasiske B, Kher V . KDIGO Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation. Transplantation. 2020; 104(4S1 Suppl 1):S11-S103. DOI: 10.1097/TP.0000000000003136. View

Lima B, Gibson G, Vullaganti S, Malhame K, Maybaum S, Hussain S . COVID-19 in recent heart transplant recipients: Clinicopathologic features and early outcomes. Transpl Infect Dis. 2020; 22(5):e13382. PMC: 7361062. DOI: 10.1111/tid.13382. View

Kute V, Bhalla A, Guleria S, Ray D, Bahadur M, Shingare A . Clinical Profile and Outcome of COVID-19 in 250 Kidney Transplant Recipients: A Multicenter Cohort Study From India. Transplantation. 2020; 105(4):851-860. PMC: 7993652. DOI: 10.1097/TP.0000000000003593. View

Dominguez-Gil B, Fernandez-Ruiz M, Hernandez D, Crespo M, Colmenero J, Coll E . Organ Donation and Transplantation During the COVID-19 Pandemic: A Summary of the Spanish Experience. Transplantation. 2020; 105(1):29-36. DOI: 10.1097/TP.0000000000003528. View

Dale M, Sogawa H, Seyedsaadat S, Wolf D, Bodin R, Partiula B . Successful Management of COVID-19 Infection in 2 Early Post-Liver Transplant Recipients. Transplant Proc. 2021; 53(4):1175-1179. PMC: 7972672. DOI: 10.1016/j.transproceed.2021.03.010. View

Raja M, Mendoza M, Villavicencio A, Anjan S, Reynolds J, Kittipibul V . COVID-19 in solid organ transplant recipients: A systematic review and meta-analysis of current literature. Transplant Rev (Orlando). 2020; 35(1):100588. PMC: 7666542. DOI: 10.1016/j.trre.2020.100588. View

Boyarsky B, Chiang T, Werbel W, Durand C, Avery R, Getsin S . Early impact of COVID-19 on transplant center practices and policies in the United States. Am J Transplant. 2020; 20(7):1809-1818. PMC: 7262146. DOI: 10.1111/ajt.15915. View

Kute V, Godara S, Guleria S, Ray D, Aziz F, Hegde U . Is it Safe to Be Transplanted From Living Donors Who Recovered From COVID-19? Experience of 31 Kidney Transplants in a Multicenter Cohort Study From India. Transplantation. 2021; 105(4):842-850. PMC: 7993648. DOI: 10.1097/TP.0000000000003609. View

Coll E, Fernandez-Ruiz M, Sanchez-Alvarez J, Martinez-Fernandez J, Crespo M, Gayoso J . COVID-19 in transplant recipients: The Spanish experience. Am J Transplant. 2020; 21(5):1825-1837. PMC: 9906239. DOI: 10.1111/ajt.16369. View

10.

Kedzierska-Kapuza K, Zielinska D, Matejak-Gorska M, Durlik M . The Course of SARS-CoV-2 in a Patient After a Recent Kidney Transplant: A Literature Review on COVID-19 Therapy. Transplant Proc. 2021; 53(4):1194-1201. PMC: 7959262. DOI: 10.1016/j.transproceed.2021.03.008. View

11.

Tchana-Sato V, Ancion A, Tridetti J, Sakalihasan N, Hayette M, Detry O . Clinical course and challenging management of early COVID-19 infection after heart transplantation: case report of two patients. BMC Infect Dis. 2021; 21(1):89. PMC: 7816134. DOI: 10.1186/s12879-021-05793-6. View

12.

Waisberg D, Abdala E, Nacif L, Ducatti L, Haddad L, Martino R . Coronavirus Disease 2019 in the Early Postoperative Period of Liver Transplantation: Is the Outcome Really So Positive?. Liver Transpl. 2020; 27(9):1357-1359. DOI: 10.1002/lt.25933. View

13.

Hadi Y, Naqvi S, Kupec J, Sofka S, Sarwari A . Outcomes of COVID-19 in Solid Organ Transplant Recipients: A Propensity-matched Analysis of a Large Research Network. Transplantation. 2021; 105(6):1365-1371. PMC: 8414593. DOI: 10.1097/TP.0000000000003670. View

14.

Grupper A, Rabinowich L, Schwartz D, Schwartz I, Ben-Yehoyada M, Shashar M . Reduced humoral response to mRNA SARS-CoV-2 BNT162b2 vaccine in kidney transplant recipients without prior exposure to the virus. Am J Transplant. 2021; 21(8):2719-2726. PMC: 8250589. DOI: 10.1111/ajt.16615. View

15.

Kolonko A, Dudzicz S, Wiecek A, Krol R . COVID-19 infection in solid organ transplant recipients: A single-center experience with patients immediately after transplantation. Transpl Infect Dis. 2020; 23(1):e13381. PMC: 7361238. DOI: 10.1111/tid.13381. View

16.

Avery R, Chiang T, Marr K, Brennan D, Sait A, Garibaldi B . Inpatient COVID-19 outcomes in solid organ transplant recipients compared to non-solid organ transplant patients: A retrospective cohort. Am J Transplant. 2020; 21(7):2498-2508. PMC: 9800757. DOI: 10.1111/ajt.16431. View

17.

Shingare A, Bahadur M, Raina S . COVID-19 in recent kidney transplant recipients. Am J Transplant. 2020; 20(11):3206-3209. PMC: 7300437. DOI: 10.1111/ajt.16120. View

18.

Boyarsky B, Werbel W, Avery R, Tobian A, Massie A, Segev D . Antibody Response to 2-Dose SARS-CoV-2 mRNA Vaccine Series in Solid Organ Transplant Recipients. JAMA. 2021; 325(21):2204-2206. PMC: 8100911. DOI: 10.1001/jama.2021.7489. View

19.

Lembach H, Hann A, McKay S, Hartog H, Vasanth S, El-Dalil P . Resuming liver transplantation amid the COVID-19 pandemic. Lancet Gastroenterol Hepatol. 2020; 5(8):725-726. PMC: 7289560. DOI: 10.1016/S2468-1253(20)30187-4. View

20.

Koczulla R, Sczepanski B, Koteczki A, Kuhnert S, Hecker M, Askevold I . SARS-CoV-2 infection in two patients following recent lung transplantation. Am J Transplant. 2020; 20(10):2928-2932. PMC: 7272871. DOI: 10.1111/ajt.15998. View