COVID-19 - Management strategies, outcome evaluation

Tuesday September 13, 2022 from 11:35 to 13:05

Room: C5

314.6 Factors effecting mortality among Covid-19 patients in Renal Transplant Recipients from a single center in Pakistan

Sunil Kumar Dodani, Pakistan

Associate Professor
Infectious Diseases
Sindh Institute of Urology and Transplantation

Abstract

Factors effecting mortality among Covid-19 patients in renal transplant recipients from a single center in Pakistan

Sunil Dodani1, Asma Nasim1, Tahir Aziz2.

1Infectious Diseases, Sindh Institute of Urology and Transplantation, Karachi, Pakistan; 2Transplant Nephrology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan

Introduction: Corona virus disease-19 (Covid-19) has significantly affected organ transplantation with concerns regarding severe infection and mortality. Data on Covid-19 in renal transplant recipients (RTRs) is scarce from Pakistan. The aim of this study is find out the factors effecting mortality among Covid-19 patients in renal transplant recipients from the largest transplant center of Pakistan.

Methods: All RTRs >18 years, with positive severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) polymerase chain reaction (PCR) and diagnosed as severe disease, between April to December 2020 were retrospectively reviewed. The severe disease was defined as O2 saturation <94% at room air on admission. Survivors and non-survivors were compared.  Demographics, immunosuppression, comorbid conditions, clinical features, laboratory investigations, and graft function were noted.

Results: A total of 95 RTRs had severe disease. There was no difference in mortality between age, gender, and co-morbid conditions among survivors and non-survivors. Both groups received a similar immunosuppressive regimen. Intensive care unit (ICU) admission [16.5% vs 68.8% p<0.001 OR 11.17 95% CI (3.3-37.6)] and high D-dimers >1.5µg/ml (p=0.052) at the time of admission were significantly associated with mortality. There was no association of graft function with mortality. Treatment with methyl-prednisolone was found to be significantly associated with survival [83% vs 43% P=0.02 OR 0.15 95% CI (0.05-0.49)]. (Table 1) WHO grading of the disease is shown in figure 1, there was a 100% mortality among patients on a mechanical ventilator.


 

Conclusion: ICU admission and high D-dimers at the time of admission are the significant risk factors for mortality in patients with Covid-19 infection. There was no association of graft dysfunction with mortality. Steroids use has significantly improved survival in renal transplant recipients with severe Covid-19 infection.



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