Impact of COVID-19 on Renal Transplant Recipients in a National Transplant Center

Renal transplant recipients are at higher risk of COVID-19 infection due to chronic comorbidities and immunocompromised state. Limited information is available in Nepal regarding this infection among organ transplantation patients.

A retrospective cross-sectional study was conducted on 601 patients to assess the impact of COVID-19 among patients who underwent renal transplant surgery at Shahid Dharmabhakta National Transplant Center (SDNTC), Bhaktapur. All the renal transplant patients who were COVID-19 confirmed through PCR tests were included. A self-developed, semi-structured telephone interview schedule was utilized for data collection.

Among the patients who responded to our telephone calls, more than a quarter (37.9%) were diagnosed as COVID-19 positive. The mortality rate was relatively low at 5.7% overall, but significantly higher at 14.9% among those with COVID-19 positive. Hypertension and diabetes mellitus were the top two comorbid conditions. The common reporting symptom was fever followed by cough. Interestingly, 23.7% of COVID-19-positive patients were hospitalized, and among them, 72.2% were admitted for more than 2 days. Notably, 65.8% of the COVID-19 patients were not vaccinated and among vaccinated ones, only 17.1% of patients were fully vaccinated. The most common vaccine was Vero Cell. There was sixfold increased chance of COVID-19 infection among unvaccinated patients than vaccinated ones. However, there was no significant association between mortality and age, sex, occupation and vaccination status.

This study highlights the heightened vulnerability of renal transplant recipients to COVID-19 as significant portion of the studied patients tested positive for COVID-19, with a notable mortality rate among these patients. The findings underscore the critical role of vaccination, as a considerable number of the COVID-19 positive patients were unvaccinated.