Korean J Transplant.  2020 Dec;34(Supple 1):S55. 10.4285/ATW2020.OP-1177.

COVID-19 infection in kidney transplant recipients: report from two centers of Bangladesh

• Salma Begum NA
• Kashem TS
• Rima FN
• Arefin SUZ
• Islam K
• Rahman R
• Rashid HU

• KMID: 2509199
• DOI: http://doi.org/10.4285/ATW2020.OP-1177

Abstract

Background
The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected people around the globe including transplant recipients. Here we report our experience of coronavirus 2019 (COVID-19) infection in kidney transplant recipients of Bangladesh.
Methods
This prospective observational study was performed in two specialized kidney hospitals of Dhaka, Bangladesh from May 2020 to August 2020.
Results
In these two centers about 1,043 kidney transplant recipients were regularly followed up. Among them 31 patients (2.97%) developed COVID-19 infection during the study period. Of them 23 patients were test positive and the remaining test negative but suspected clinically and radiologically. Average age of recipients was 38.3±6.9 years (23–53). Twenty-eight recipients were male (90.3%) and three were female (9.7%). Fever was the most common presentation (100%), followed by cough (80.6%), shortness of breath (35.5%), diarrhoea (12.9%), generalized weakness (12.9%), loss of taste (9.7%), headache (6.5%), body ache (6.5%), throat pain (3.2%), chest pain (3.2%), abdominal pain (3.2%), and orbital cellulitis (3.2%). On investigation, leukocyte count was normal in 77% cases and raised in 19.2% cases and lymphopenia was observed in 69.2% cases. C-reactive protein (CRP) was found high in 63.6% recipients. Chest X-ray showed pneumonic changes in 80.6% (25/31) cases. Flavipiravir was given to 20 transplant recipients (64.5%). Five patients (16.1%) developed acute kidney injury (AKI); one patient improved and four patients (80%) had died, three patients required dialysis. The overall mortality rate was 22.6% (7 out of 31); three patients had severe AKI (42.8%), two developed acute respiratory distress syndrome (28.6%) and two developed cerebrovascular disease (28.6%).
Conclusions
In summary kidney transplant recipients in our centers had a higher rate of COVID-19 infection and higher rate of mortality than the general population (22.6% vs. 1.4%). Patients who developed AKI had a higher mortality rate.