Outcomes of Renal Transplant Recipients With SARS-CoV-2 Infection in the Eye of the Storm: A Comparative Study With Waitlisted Patients
- Resource Type
- Authors
- Ismail H, Mohamed; Prashanth B, Chowdary; Shraddha, Shetty; Cinzia, Sammartino; Rajesh, Sivaprakasam; Ben, Lindsey; Raj, Thuraisingham; Muhammad M, Yaqoob; Muhammad A, Khurram
- Source
- Transplantation. 105(1)
- Subject
- Adult
Immunosuppression Therapy
Male
Waiting Lists
SARS-CoV-2
COVID-19
Comorbidity
Middle Aged
Kidney Transplantation
Transplant Recipients
Immunocompromised Host
Humans
Kidney Failure, Chronic
RNA, Viral
Female
Prospective Studies
Pandemics
Immunosuppressive Agents
Aged
Follow-Up Studies
- Language
- ISSN
- 1534-6080
Patients with chronic kidney disease stage 5 and those on immunosuppression are particularly vulnerable and are shielded as per public health strategy. We present our experience of coronavirus disease 2019 (COVID-19) transplant patients in one of the most affected parts of the UK with direct comparison to waitlisted patients.A single-center prospective study of symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive waitlisted and transplant patients was undertaken to compare these groups and assess clinical outcomes.A total of 60 consecutive symptomatic SARS-CoV-2 positive patients were identified with 32 active waitlisted patients and 28 functioning renal transplants. Demographics were similar. The incidence of symptomatic COVID-19 in the waitlisted group was 9.9% compared to 1.9% in renal transplant patients (P0.001). Immunosuppression did not influence initial symptomology. Fifteen percent of patients in the waitlisted and 32% in the transplant groups died (P = 0.726). Mortality as proportion of total waitlisted (321 patients) and transplant population (1434 patients) of our centre was 1.5% and 0.6% (P0.001), respectively. C-reactive protein (CRP) at 48 h and peak CRP were associated with mortality in both groups while quick sequential organ failure assessment score at 48 h (P = 0.036) was associated with mortality for transplant patients.Incidence of COVID-19 is higher in the waitlisted population but transplant patients have more severe disease, reflected by higher mortality. CRP at 48 h can be used as a predictive tool. In the absence of effective treatments, the current strategy of shielding is arguably the most important factor in protecting patients while resuming transplantation.