Outcome of COVID-19 in Egyptian living-donor kidney transplant recipients and relation to maintenance immunosuppressive drugs: a pilot study
Abstract Coronavirus disease 2019 (COVID-19) in kidney transplant recipients is a subject of much debate and became of interest to nephrologists amidst the pandemic. The main concerns are the influence of the chronic use of immunosuppressive drugs, the viral-related risk of acute rejection, and the...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2023-11-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-45750-8 |
| _version_ | 1797376991253495808 |
|---|---|
| author | Maggie Said ElNahid Marianne Samir Makboul Issac Khaled Marzouk Sadek |
| author_facet | Maggie Said ElNahid Marianne Samir Makboul Issac Khaled Marzouk Sadek |
| author_sort | Maggie Said ElNahid |
| collection | DOAJ |
| description | Abstract Coronavirus disease 2019 (COVID-19) in kidney transplant recipients is a subject of much debate and became of interest to nephrologists amidst the pandemic. The main concerns are the influence of the chronic use of immunosuppressive drugs, the viral-related risk of acute rejection, and the long-term outcome of allograft function. This single-center prospective study included kidney transplant recipients with COVID-19 infection. Patients were maintained on immunosuppressive regimens. The severity of disease was defined as oxygen saturation < 94%, the need for hospitalization and/or hemodialysis, the occurrence of acute kidney injury (AKI), and mortality. Seventeen patients (54.8%) required hospital admission, four patients needed hemodialysis (12.9%), twelve patients (38.7%) had AKI, and three patients died (9.7%). Oxygen saturation < 94% showed a positive correlation with the presence of diabetes (p value 0.031) and a negative correlation with the maintenance steroid dose (p value 0.046). A negative correlation existed between the need for hemodialysis and average Cyclosporin level (p value 0.019) and between the need for hospitalization and average Tacrolimus level (p value 0.046). Severity of disease was associated with the presence of lymphopenia (p value 0.042), the cumulative steroid dose (p value 0.001), increased serum levels of LDH (p value 0.010), Ferritin (p value 0.020), AST (p value 0.047), and ALT (p value 0.006) and D-dimer levels more than 0.5 mg/L (p value 0.038). This study highlighted that the immunocompromised state of renal transplant recipients may not be regarded as a disadvantage in the setting of COVID-19 infection. Studies on a larger scale are needed to validate these results. |
| first_indexed | 2024-03-08T19:46:31Z |
| format | Article |
| id | doaj.art-94d400c569c341d6ac3586077a615467 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-08T19:46:31Z |
| publishDate | 2023-11-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-94d400c569c341d6ac3586077a6154672023-12-24T12:19:28ZengNature PortfolioScientific Reports2045-23222023-11-011311810.1038/s41598-023-45750-8Outcome of COVID-19 in Egyptian living-donor kidney transplant recipients and relation to maintenance immunosuppressive drugs: a pilot studyMaggie Said ElNahid0Marianne Samir Makboul Issac1Khaled Marzouk Sadek2Department of Internal Medicine and Nephrology, Faculty of Medicine, Cairo UniversityDepartment of Clinical and Chemical Pathology, Faculty of Medicine, Cairo UniversityDepartment of Internal Medicine and Nephrology, Faculty of Medicine, Cairo UniversityAbstract Coronavirus disease 2019 (COVID-19) in kidney transplant recipients is a subject of much debate and became of interest to nephrologists amidst the pandemic. The main concerns are the influence of the chronic use of immunosuppressive drugs, the viral-related risk of acute rejection, and the long-term outcome of allograft function. This single-center prospective study included kidney transplant recipients with COVID-19 infection. Patients were maintained on immunosuppressive regimens. The severity of disease was defined as oxygen saturation < 94%, the need for hospitalization and/or hemodialysis, the occurrence of acute kidney injury (AKI), and mortality. Seventeen patients (54.8%) required hospital admission, four patients needed hemodialysis (12.9%), twelve patients (38.7%) had AKI, and three patients died (9.7%). Oxygen saturation < 94% showed a positive correlation with the presence of diabetes (p value 0.031) and a negative correlation with the maintenance steroid dose (p value 0.046). A negative correlation existed between the need for hemodialysis and average Cyclosporin level (p value 0.019) and between the need for hospitalization and average Tacrolimus level (p value 0.046). Severity of disease was associated with the presence of lymphopenia (p value 0.042), the cumulative steroid dose (p value 0.001), increased serum levels of LDH (p value 0.010), Ferritin (p value 0.020), AST (p value 0.047), and ALT (p value 0.006) and D-dimer levels more than 0.5 mg/L (p value 0.038). This study highlighted that the immunocompromised state of renal transplant recipients may not be regarded as a disadvantage in the setting of COVID-19 infection. Studies on a larger scale are needed to validate these results.https://doi.org/10.1038/s41598-023-45750-8 |
| spellingShingle | Maggie Said ElNahid Marianne Samir Makboul Issac Khaled Marzouk Sadek Outcome of COVID-19 in Egyptian living-donor kidney transplant recipients and relation to maintenance immunosuppressive drugs: a pilot study Scientific Reports |
| title | Outcome of COVID-19 in Egyptian living-donor kidney transplant recipients and relation to maintenance immunosuppressive drugs: a pilot study |
| title_full | Outcome of COVID-19 in Egyptian living-donor kidney transplant recipients and relation to maintenance immunosuppressive drugs: a pilot study |
| title_fullStr | Outcome of COVID-19 in Egyptian living-donor kidney transplant recipients and relation to maintenance immunosuppressive drugs: a pilot study |
| title_full_unstemmed | Outcome of COVID-19 in Egyptian living-donor kidney transplant recipients and relation to maintenance immunosuppressive drugs: a pilot study |
| title_short | Outcome of COVID-19 in Egyptian living-donor kidney transplant recipients and relation to maintenance immunosuppressive drugs: a pilot study |
| title_sort | outcome of covid 19 in egyptian living donor kidney transplant recipients and relation to maintenance immunosuppressive drugs a pilot study |
| url | https://doi.org/10.1038/s41598-023-45750-8 |
| work_keys_str_mv | AT maggiesaidelnahid outcomeofcovid19inegyptianlivingdonorkidneytransplantrecipientsandrelationtomaintenanceimmunosuppressivedrugsapilotstudy AT mariannesamirmakboulissac outcomeofcovid19inegyptianlivingdonorkidneytransplantrecipientsandrelationtomaintenanceimmunosuppressivedrugsapilotstudy AT khaledmarzouksadek outcomeofcovid19inegyptianlivingdonorkidneytransplantrecipientsandrelationtomaintenanceimmunosuppressivedrugsapilotstudy |