COVID-19 in Renal Transplant Recipients and Waiting List Patients

Pavankumar Kamat

January 11, 2021

A study published in the journal  Transplantation  indicates that patients in the UK awaiting renal transplant have a significantly higher incidence of COVID-19, but transplant recipients are likely to have more severe disease and higher mortality.

In a single-centre prospective study, researchers assessed COVID-19 incidence and outcomes among SARS-CoV-2- positive individuals who were either awaiting renal transplant (n=32) or had a functioning transplant (n=28).

The incidence of symptomatic COVID-19 among waitlisted patients was 9.9 per cent compared with 1.9 per cent among renal transplant recipients (P<.001). Although immunosuppressed patients are known to exhibit diminished symptoms and sometimes delayed presentation, immunosuppression did not have any influence on the initial symptomatology in this study.

The mortality rate was 15 per cent in the waitlisted group versus 32 per cent in the transplant group (P=.726). C-reactive protein (CRP) at 48 hours and peak CRP were predictive of mortality in both groups, whereas quick sequential organ failure assessment score at 48 hours (P=.036) was predictive of mortality for transplant recipients.

"Mortality is very high in both groups on contracting the disease hence in the absence of effective treatments, shielding remains the only nonpharmacological strategy that is protective for these patients," the authors stated.

Mohamed IH, Chowdary PB, Shetty S, Sammartino C, Sivaprakasam R, Lindsey B, Thuraisingham R, Yaqoob MM, Khurram MA. Outcomes of Renal Transplant Recipients With SARS-CoV-2 Infection in the Eye of the Storm: A Comparative Study With Waitlisted Patients. Transplantation. 2021;105(1):115-120. doi: 10.1097/TP.0000000000003406. PMID: 33350626 View full text

This article originally appeared on Univadis, part of the Medscape Professional Network.

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