A Retrospective and Comparative Analysis of Clinical Outcomes of Kidney Transplant Recipients During First and Second...

Area of Science:

• Nephrology
• Infectious Diseases
• Immunology

Background:

• Kidney transplant recipients (KTRs) face increased COVID-19 risk due to immunosuppression.
• COVID-19 waves have shown varying impacts on general populations.
• Understanding wave-specific effects in KTRs is crucial for patient management.

Purpose of the Study:

• To analyze the impact of different COVID-19 waves on kidney transplant recipients.
• To identify predictors of survival and allograft dysfunction in KTRs during distinct COVID-19 waves.
• To evaluate the role of immunosuppression modification in COVID-19 outcomes for KTRs.

Main Methods:

• Retrospective, single-center study in North India.
• Inclusion of 112 kidney transplant recipients infected with COVID-19 across two waves.
• Analysis of clinical data, disease severity, and outcomes based on COVID-19 wave.

Main Results:

• Higher incidence of severe COVID-19 (79%) in the first wave versus the second (50%).
• Similar mortality rates between waves; severe disease and hospitalization predicted survival.
• Increased allograft dysfunction in the second wave (7 vs. 1), linked to baseline creatinine.

Conclusions:

• The first COVID-19 wave caused more severe disease in KTRs, while the second wave led to greater allograft dysfunction.
• Healthcare access limitations during the second wave likely contributed to poorer allograft outcomes.
• Immunosuppression adjustments did not demonstrate survival benefits, despite being necessary for infection management.