Korean J Transplant.  2022 Nov;36(Supple 1):S304. 10.4285/ATW2022.F-4427.

Clinical presentation and outcomes of the COVID-19 infection in kidney transplant patients

• Min K
• Han M
• Jeong H
• Kim H
• Kim O
• Lee S
• Lee S
• Kim J
• Han A
• Ha J

• KMID: 2535531
• DOI: http://doi.org/10.4285/ATW2022.F-4427

Abstract

Background
While COVID-19 poses a significant threat to immunocompromised patients, there is limited data on the clinical course and the risk factors for severe disease in the Korean transplant population. We have performed a single-center, cross-sectional, survey-based study to evaluate the clinical presentation, treatments, and outcomes of COVID-19 infection among renal transplant recipients (RTRs).
Methods
Eligible patients were adult RTRs who had reported confirmed COVID-19 infection. We conducted an electronic sur-vey using a structured questionnaire via Google Forms to collect information on symptoms and treatments sought during the infection. The data were combined with data documented in the electronic health report.
Results
Among 2,250 adult RTRs, 239 patients (10.6%) had experienced COVID-19 infection. Patients had a mean age of 49 years, 56.9% (n=136) were male, and 77.1% (n=182) had received transplantation from a living donor. Patients had experienced COVID-19 infection after one (n=217, 90.7%), two (n=315, 89.9%), and three doses (n=185, 77.4%) of vaccination, respectively. The mean period between the prior vaccination and infection was 84 days. The most common route of infection was family (n=100, 42%) followed by unknown and multi-use facilities. Main symptoms were cough (n=158, 66.1%), sore throat (n=145, 60.7), and fever (n=129, 54.0%). The majority of the patients were infected during the Omicron surge (n=221,92.4%) and initially received home treatment with upper respiratory infection medications (n=181, 75.7%) only. 13 patients experienced severe disease (World Health Organization severity scale), and there were (n=2, 0.8%) mortalities. Factors independently associated with COVID-19 disease were old age (odds ratio [OR], 1.08), diabetes (OR, 5.39), low hemoglobin (OR, 0.71), and high neutrophil-lymphocyte ra-tio (OR, 1.28) in the multivariate logistic model.
Conclusions
The mortality rate associated with COVID-19 disease was higher in kidney transplantation patients than in the general population. Age, diabetes, hemoglobin levels, and Neutrophil-to-lymphocyte ratio were factors associated with the severe COVID-19 disease. Larger studies are warranted to confirm these findings.