Result of the Transplant Patients
Our hospital was accepted as a pandemic hospital after March 11, 2020,
following the first case of COVID-19 seen in our country. As of this
date, the kidney transplant program was temporarily suspended until
March 2021. Ambulatory service for follow-ups of transplant patients was
continued. Treatments of patients were arranged and prescribed through
the teleconference method as far as possible. Fifty-eight transplant
(female: 21/36.2%; Male:37/63.8%) patients with COVID-19 infection
were included. The median age was 44.5 years (28.7-55.2). Median time
between the time of transplantation and diagnosis of COVID-19 infection
was 71 months (25-140). Fifty-four (93.1%) of patients were
PCR-confirmed. Laboratory and imaging findings of the other 4 patients
were compatible with COVID-19 infection. There were no findings in the
18 (31%) patients in the imaging. The most common CT findings were
bilateral ground-glass findings and diffuse opacities. The most common
symptom was myalgia and arthralgia (n:37/63.8%).
The most common cause of kidney failure was diabetic nephropathy. The
most common accompanying disease was hypertension (39/67.2%). One of
our patients was being treated with Eculuzimab due to atypical hemolytic
syndrome (AHUS) postoperatively. (Table 3)
The rate of use of the hydroxychloroquine was 12.1%. Most of the
patients were treated with favipiravir (50/86.2%) and Low Molecular
Weight Hepatin (LMWH). Antibiotics were administered in the 41 (70.7%)
patients for profilaxia or due to seconder infecction. Mean time of
hospitalization was 10 days (6-14). Ten patients (17.2%) were treated
in the intensive care unit. Nine (22.5%) of hospitalized patients died.
The median time between the onset of symptoms and admission to the
hospital was 3 (2-5) days. And this rate was 2 (2-3) and 5 (4-5.75)
days, respectively, for patients followed up in our center and the
external centers (p<0.001). In addition, the hospitalization
rates of these patients were 60% (n: 24/40) and 89% (n: 16/18),
respectively (p: 0.034).
There was no statistically significant difference between the kidney
transplant and hemodialysis patients in terms of mortality. Nonetheless,
mortality rate was high among the young patients in the transplant group
(p:0.001). In addition, first-year cases where immunosuppression was
taken most intensively due to the interruption of kidney transplantation
in the first year of the pandemic were not included in the study.