Session Name: All Infections (Excluding Kidney & Viral Hepatitis)
Session Date & Time: None. Available on demand.
*Purpose: Kidney transplant recipients are at increased risk of severe disease and death caused by Coronavirus-19 infection. The role of immunosuppressive medications in the clinical presentation, disease course, and outcomes is not well understood.
*Methods: We analyzed kidney transplant recipients diagnosed with Coronarvirus-19 infection during the initial infection surge requiring hospitalization at two large transplant centers in New Orleans, LA, between February 1, 2020, and April 30, 2020. Patient presentation, clinical course, kidney transplant function, and post-discharge details were included in this analysis.
*Results: Twenty-three kidney transplant recipients hospitalized with Coronavirus-19 infection were included in the study. The majority of the patients were black (95.7%). Diabetes, hypertension, and obesity were present in at least 50% of the patients. The most common presenting symptom was fever, present in 52.2% of patients. All patients were managed with a reduction in immunosuppression. 60.9% of patients received azithromycin, 47.8% received hydroxychloroquine, 8.7% received remdesivir, and 8.7% received IV methylprednisolone pulse. The average length of stay was approximately 4.5 days (range 2 to 18 days). 73.9% of the patients sustained acute kidney injury, with an average peak serum creatinine of 3.81 mg/dL. 26% of the patients required renal replacement therapy. 77% of patients developed proteinuria (at least +1 proteinuria on urinalysis). 37.5% of patients required mechanical ventilation, and of these, 77.8% died. Overall, 30.4% of patients died of Coronavirus-19 infection-related complications during admission. Of the 16 patients discharged, the average serum creatinine during the first follow-up visit was 2.09 mg/dL compared with an average preadmission serum creatinine of 1.76 mg/dL.
*Conclusions: During the initial Coronavirus-19 infection surge in New Orleans, we noted that kidney transplant recipients had initial symptoms similar to the general population. However, we recorded a high incidence of acute kidney injury and the need for renal replacement therapy. Patients who required mechanical ventilation had a high mortality rate. There was an over-representation of black patients.
To cite this abstract in AMA style:Giusti S, Chazin S, Vaitla P, Atiemo K, Atari M, Paramesh A, Jeon H, Vijay A, Torres A, Killackey M, Thimmisetty R, Garces J. Observational Study of the Clinical Characteristics and Short-term Outcomes of Kidney Transplant Recipients Diagnosed with Coronavirus-19 Infection (sars-cov2) Requiring Hospitalization in New Orleans [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/observational-study-of-the-clinical-characteristics-and-short-term-outcomes-of-kidney-transplant-recipients-diagnosed-with-coronavirus-19-infection-sars-cov2-requiring-hospitalization-in-new-orleans/. Accessed June 16, 2021.
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