Clinical manifestations and factors associated with mortality from COVID-19 in kidney transplant recipients in a Colombian center

Clinical manifestations and factors associated with mortality from COVID-19 in kidney transplant recipients in a Colombian center

Dania V. Carreño-Barrera 1, Ma. Alejandra Lizarazo-Hernández 2, Iván D. Ortiz-Pulido 2, Carmenza Murcillo-Pianeta 3, Juan P. Álzate-Granados 4 , William Fajardo-Cediel 5, David A. Castañeda-Millán 6

1 Unidad de Urología, Facultad de Medicina, Universidad Militar Nueva Granada, Bogotá, Colombia; 2 Unidad de Urología, Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia; 3 Facultad de Medicina, Universidad del Norte, Barranquilla, Colombia; 4 Grupo de Investigación e Innovación en Urología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; 5 Unidad de Urología y Trasplante Renal, Fundación Clínica Shaio, Bogotá, Colombia; 6 Unidad de Urología, Departamento de Cirugía, Facultad de Medicina, Universidad Nacional de Colombia; Grupo de Investigación e Innovación en Urología, Facultad de Medicina, Universidad Nacional de Colombia; Bogotá, Colombia

*Correspondence: David A. Castañeda-Millán. Email: dacastanedam@unal.edu.co

Abstract

Objective: Kidney transplant (KTx) recipients have a high burden of comorbidities and are at increased risk of death from coronavirus disease 2019 (COVID-19). Our objective is to describe the clinical manifestations and outcomes in a group of KTx recipients with COVID-19 and to define factors associated with mortality.

Methods: Cross-sectional study that included the retrospective review of clinical records of KTx recipients diagnosed with COVID-19 between March 2020 and February 2022 in a transplant center in Bogotá (Colombia). A bivariate and multivariate analysis was performed to establish associations between the variables of interest and the primary outcome (mortality).

Results: Ninety-four cases were included. 71.28% had a KTx, mainly from a cadaveric donor. Clinical manifestations included cough in 79.7%, fever in 50%, and dyspnea in 42.55% of cases. The overall mortality rate was 18.09%. In 54.9% an immunosuppressive adjustment was made, with complete interruption of the scheme in up to 74% of these cases.

Conclusions: The mortality rate evidenced in KTx recipients with COVID-19 is higher than in general population. The severity of the COVID-19 in this group frequently requires adjustments to immunosuppressive therapy. The factors associated with mortality were dyspnea, the need for orotracheal intubation and intensive care unit stay.

Keywords: Kidney transplantation. COVID-19. Tissue and organ procurement.

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