Korean J Transplant.  2022 Nov;36(Supple 1):S192. 10.4285/ATW2022.F-3212.

Single center experience of COVID-19 management among kidney transplant recipient in Omicron pandemic

• Huh H
• Kim B
• Kim Y
• Kim T
• Kim YH

• KMID: 2535708
• DOI: http://doi.org/10.4285/ATW2022.F-3212

Abstract

Background
Omicron variants of coronavirus disease 2019 (COVID-19) have been prevalent since 2021. Kidney transplant re-cipients have a lower response rate to the vaccine and are considered a high-risk group for mortality and complications from COVID-19 infection. This study aimed to investigate the outcome of COVID-19 in kidney transplant patients in which omicron variants were prevalent.
Methods
This retrospective study included kidney transplant recipients with COVID-19 from a single center. Patients diagnosed with COVID-19 were subjected to self-quarantine with supportive care unless there was no evidence of serious diseases such as pneumonia. We conducted the surveillance to evaluate whether pneumonia develops at end of quarantine. Patients who progressed to pneumonia or severe disease at diagnosis were hospitalized and administered antiviral agents and steroids regardless of the time after diagnosis. We investigated all-cause mortality in kidney transplant recipients with COVID-19.
Results
A total of 106 recipients were enrolled. The mean age of the patients was 54.6±11.2 years, and 51.9% were female. The median time from transplant to diagnosis of COVID-19 was 112 (57–161) months. The prevalence of hypertension, diabetes, and cardiovascular disease were 63.2%, 42.5%, and 19.8%, respectively. The most common symptoms were upper respiratory tract symptoms including sore throat (34%). Ninety-four patients had mild disease, pneumonia and severe disease occurred in 10 patients. Of 94 patients with mild disease, 19 (20.2%) patients developed pneumonia at end of quarantine and were hospi-talized. The median time from diagnosis of COVID-19 to the antiviral agent (34%) and steroid (25%) was a median of 10 (1–14) days. The all-cause mortality rate was 2.8%.
Conclusions
Unlike previous studies, COVID-19-related mortality was very low. This could reflect the characteristics of the omicron variants and the effect of vaccination. However, there is a possibility that active surveillance and treatment of pneumonia regardless of the severity reduced mortality.