A Retrospective and Comparative Analysis of Clinical Outcomes of Kidney Transplant Recipients During First and Second COVID-19 Waves in North-West India.

Autor:	Bhagat C; Nephrology, Institute of Liver and Biliary Sciences, New Delhi, IND., Gurnani N; Urology, Employees' State Insurance Corporation (ESIC) Hospital, Faridabad, IND., Godara S; Nephrology, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, IND., Mathur R; Nephrology, Institute of Liver and Biliary Sciences, New Delhi, IND., Goel A; Nephrology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND., Meshram HS; Nephrology, Institute of Liver and Biliary Sciences, New Delhi, IND.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jan 05; Vol. 16 (1), pp. e51693. Date of Electronic Publication: 2024 Jan 05 (Print Publication: 2024).
DOI:	10.7759/cureus.51693
Abstrakt:	Introduction Kidney transplant recipients (KTRs) are prone to coronavirus disease 2019 (COVID-19) disease secondary to chronic immunosuppressive therapy. There have been differences in mortality and morbidity amongst the general population with different COVID-19 waves. This study is done to understand the effects of different COVID-19 waves amongst KTRs. Methods This was a retrospective single-centre trial from a high-volume transplant centre in North India. The immunosuppression protocol was changed according to national guidelines, and predictors of survival were evaluated. Results A total of 62 patients got infected during the first COVID-19 wave (March 2020 to February 2021) and 50 patients during the second COVID-19 wave (March 2021 to December 2021). Analysis showed a higher incidence of severe COVID-19 disease (79% vs. 50%) in the first wave, while the rest of the baseline parameters were similar in both waves. Mortality was similar in both groups. In both groups, severe COVID-19 disease, the requirement of hospitalisation, invasive oxygen therapy, and CT score findings were significant predictors of survival. There was no change in survival with respect to immunosuppression modification. Allograft dysfunction was more common in the second wave (7 vs. 1). Baseline creatinine was significantly associated with allograft dysfunction in follow-up. Conclusion Patients had severe COVID-19 disease during the first wave; however, poor availability of healthcare services during the second wave led to more patients with allograft dysfunction. Though immunosuppression change is necessary to prevent flare-ups of COVID-19 infection, it is not associated with survival benefits. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Bhagat et al.)
Databáze:	MEDLINE
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