Clinical characteristics and outcome of novel coronavirus disease in kidney transplant recipients: A single-center prospective observational study
Background: Organ transplant recipients are at increased risk of infections which may result in acute graft dysfunction and death. Coronavirus disease (COVID-19) is the ongoing global infectious challenge and little is known about the impact of this novel virus in kidney transplant recipients. We he...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Indian Journal of Transplantation |
| Subjects: | |
| Online Access: | http://www.ijtonline.in/article.asp?issn=2212-0017;year=2021;volume=15;issue=3;spage=189;epage=198;aulast= |
| _version_ | 1818835720082554880 |
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| author | Venkatesh Arumugam Bhagavatula V. R. H. Sastry Dolphin J Solomon Natarajan Gopalakrishnan Badri Srinivasan Kannan P Shankar N Sheik Sulthan Alavudeen Shivakumar Dakshinamoorthy Malathy Natarajan |
| author_facet | Venkatesh Arumugam Bhagavatula V. R. H. Sastry Dolphin J Solomon Natarajan Gopalakrishnan Badri Srinivasan Kannan P Shankar N Sheik Sulthan Alavudeen Shivakumar Dakshinamoorthy Malathy Natarajan |
| author_sort | Venkatesh Arumugam |
| collection | DOAJ |
| description | Background: Organ transplant recipients are at increased risk of infections which may result in acute graft dysfunction and death. Coronavirus disease (COVID-19) is the ongoing global infectious challenge and little is known about the impact of this novel virus in kidney transplant recipients. We here describe the clinical presentations, laboratory profile, and outcomes of 42 such patients, from a large tertiary care center in south India. Materials and Methods: This prospective, observational study included all renal transplant recipients with confirmed COVID-19 by reverse transcription polymerase chain reaction from the start of the outbreak till August, 2020. Clinical features at presentation, laboratory and radiological data, and outcomes were analyzed. Results: Forty-two patients were included in the analysis. As many as, 86.7% patients of our cohort had symptoms at presentation, with the most common symptoms being fever (52.5%), breathlessness (50%), and cough (40.5%). Significant need for respiratory support was noted in individuals with longer duration posttransplant (P < 0.03). Acute worsening of allograft function was observed in 22 (52.4%) patients. Fourteen (65%) of them had acute on chronic graft dysfunction and acute graft dysfunction was noted in 8 (35%) patients. Six patients (14.5%) died due to the disease and none of the parameters were found to be an independent predictor of mortality in regression analytic models including acute graft dysfunction (P = 0.49) or acute on chronic graft dysfunction (P = 0.07). There was no correlation between disease severity and baseline immunosuppressive agents whether tacrolimus or cyclosporine (P = 0.57) and mycophenolate mofetil or azathioprine (P = 0.91). Conclusions: Our largest cohort of patients from India showed higher incidence of acute graft dysfunction and significant mortality in patients with COVID-19. |
| first_indexed | 2024-12-19T02:55:11Z |
| format | Article |
| id | doaj.art-15a99334129e45c687cd1b69b2833fe0 |
| institution | Directory Open Access Journal |
| issn | 2212-0017 2212-0025 |
| language | English |
| last_indexed | 2024-12-19T02:55:11Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Transplantation |
| spelling | doaj.art-15a99334129e45c687cd1b69b2833fe02022-12-21T20:38:21ZengWolters Kluwer Medknow PublicationsIndian Journal of Transplantation2212-00172212-00252021-01-0115318919810.4103/ijot.ijot_137_20Clinical characteristics and outcome of novel coronavirus disease in kidney transplant recipients: A single-center prospective observational studyVenkatesh ArumugamBhagavatula V. R. H. SastryDolphin J SolomonNatarajan GopalakrishnanBadri Srinivasan KannanP ShankarN Sheik Sulthan AlavudeenShivakumar DakshinamoorthyMalathy NatarajanBackground: Organ transplant recipients are at increased risk of infections which may result in acute graft dysfunction and death. Coronavirus disease (COVID-19) is the ongoing global infectious challenge and little is known about the impact of this novel virus in kidney transplant recipients. We here describe the clinical presentations, laboratory profile, and outcomes of 42 such patients, from a large tertiary care center in south India. Materials and Methods: This prospective, observational study included all renal transplant recipients with confirmed COVID-19 by reverse transcription polymerase chain reaction from the start of the outbreak till August, 2020. Clinical features at presentation, laboratory and radiological data, and outcomes were analyzed. Results: Forty-two patients were included in the analysis. As many as, 86.7% patients of our cohort had symptoms at presentation, with the most common symptoms being fever (52.5%), breathlessness (50%), and cough (40.5%). Significant need for respiratory support was noted in individuals with longer duration posttransplant (P < 0.03). Acute worsening of allograft function was observed in 22 (52.4%) patients. Fourteen (65%) of them had acute on chronic graft dysfunction and acute graft dysfunction was noted in 8 (35%) patients. Six patients (14.5%) died due to the disease and none of the parameters were found to be an independent predictor of mortality in regression analytic models including acute graft dysfunction (P = 0.49) or acute on chronic graft dysfunction (P = 0.07). There was no correlation between disease severity and baseline immunosuppressive agents whether tacrolimus or cyclosporine (P = 0.57) and mycophenolate mofetil or azathioprine (P = 0.91). Conclusions: Our largest cohort of patients from India showed higher incidence of acute graft dysfunction and significant mortality in patients with COVID-19.http://www.ijtonline.in/article.asp?issn=2212-0017;year=2021;volume=15;issue=3;spage=189;epage=198;aulast=covid-19immunosuppressedkidneytransplant |
| spellingShingle | Venkatesh Arumugam Bhagavatula V. R. H. Sastry Dolphin J Solomon Natarajan Gopalakrishnan Badri Srinivasan Kannan P Shankar N Sheik Sulthan Alavudeen Shivakumar Dakshinamoorthy Malathy Natarajan Clinical characteristics and outcome of novel coronavirus disease in kidney transplant recipients: A single-center prospective observational study Indian Journal of Transplantation covid-19 immunosuppressed kidney transplant |
| title | Clinical characteristics and outcome of novel coronavirus disease in kidney transplant recipients: A single-center prospective observational study |
| title_full | Clinical characteristics and outcome of novel coronavirus disease in kidney transplant recipients: A single-center prospective observational study |
| title_fullStr | Clinical characteristics and outcome of novel coronavirus disease in kidney transplant recipients: A single-center prospective observational study |
| title_full_unstemmed | Clinical characteristics and outcome of novel coronavirus disease in kidney transplant recipients: A single-center prospective observational study |
| title_short | Clinical characteristics and outcome of novel coronavirus disease in kidney transplant recipients: A single-center prospective observational study |
| title_sort | clinical characteristics and outcome of novel coronavirus disease in kidney transplant recipients a single center prospective observational study |
| topic | covid-19 immunosuppressed kidney transplant |
| url | http://www.ijtonline.in/article.asp?issn=2212-0017;year=2021;volume=15;issue=3;spage=189;epage=198;aulast= |
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