THE RISK FACTORS OF COVID-19 ADVERSE OUTCOME AND FOLLOW-UP TWO-YEAR SURVIVAL RATE IN THE KIDNEY TRANSPLANT RECIPIENTS

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https://storage.unitedwebnetwork.com/files/1099/15fe748ee4e74cbeb50ae0a33570cdef.pdf

Abstract Title

First Name *

Eugene

Last Name *

Zeltyn-Abramov

Co-author 1

Mariana Lysenko gkb52@zdrav.mos.ru 1. Moscow City Clinical Hospital 52, Russian Federation, 2. Pirogov Russian National Research Medical University, Moscow, Russian Federation MD, PhD, Chief of MCCH52 Moscow

Co-author 2

Ruslan Trushkin uro52@mail.ru Moscow City Clinical Hospital 52, Russian Federation MD, PhD, Head of Urology Department Moscow

Co-author 3

Svetlana Kondrashkina kras6989@mail.ru Moscow City Clinical Hospital 52, Russian Federation MD, Cardiologist Moscow

Co-author 4

Natalya Belavina natbelavina@mail.ru Moscow City Clinical Hospital 52, Russian Federation MD, PhD, Сardio-Nephrology Laboratory Moscow

Co-author 5

Nataliya Klochkova natalidoc1978@mail.ru 1. Moscow City Clinical Hospital 52, Russian Federation, 2. Pirogov Russian National Research Medical University, Moscow, Russian Federation MD, Ultrasound Diagnostics Department Moscow

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

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Introduction

The kidney transplant recipients (KTR) are at a high risk of COVID-19 adverse outcome.

Aim: The identification of predictors of COVID-19 adverse outcome in KTR and two-year survival analysis of discharged patients.

Methods

53 KTR with COVID-19 admitted to hospital from 04.15.20 to 07.15.20 were included in the study. The total observation period was 04.15.20 – 07.15.22. Data were collected from electronic medical database and outpatient records.

Results

A total of 53 patients were included. The mediana age was 47 y [42; 58], females 39.6 %. In-hospital mortality – 8 (15 %) patients. The independent predictors of COVID-19 adverse outcome were detected using a single factor analysis (odds ratio): fasting blood glucose (at the next day after hospitalization) ≥ 7 mmol/L (OR, 17.08; 95% CI, 2.94–69.44), proteinuria ≥ 0.6 g/L (ОR 13.87; CI, 2.35–61.74), serum creatinine ≥ 200 mcmol/L (OR 6.0; 95% CI, 2.07–33.38), NEWS2-scale points at admission ≥ 5 points (OR 24.5; 95% CI, 2.68–33.5), C-reactive protein/albumine serum ratio at admission ≥ 2 (ОR 1.65; 95% CI 0.36–7.46).

The analysis of the frequency of occurrence of septic complications was done: systemic inflammatory response syndrome (4 patients (7.5 %)), catheter-related bloodstream infection (9 (17 %)), nosocomial pneumonia (9 (17 %)). The occurrence of cardiovascular events was also analyzed: acute myocardial infarction (2 3.8 %)), pulmonary embolism (1 (1.9 %)), Takotsubo cardiomyopathy (1 (1.9 %)). The incidence of development of dialysis-requiring renal transplant disfunction was studied. Septic complications were detected in all non-survivors: 8 (100 %) (non-survivors) vs 14 (31 %) (survivors), p = 0.0003. Dialysis-requiring renal transplant disfunction was detected in all non-survivors: 8 (100 %) (non-survivors) vs 33 (73%) (survivors), p = 0.097, respectively. A kidney graft function completely restored in 26 patients (survivors). A statistically significant prevalence of cardiovascular events was detected among non-survivors: 4 (50 %) (non-survivors) vs 2 (4.4 %) (survivors), p = 0.043. 2 patients died after hospital discharge (4.4 %). The causes of death were acute stroke and oncology. The dialysis-requiring renal transplant disfunction developed in 3 patients. The results of the two-year cumulative survival are presented at the Figure 1.

Conclusions

Key risk factors for COVID-19 adverse outcome in KTR include glucose tolerance disorder, markers of systemic inflammatory response severity and renal graft disfunction. Septic events and dialysis-requiring kidney injury were the most common complications in the observation cohort.

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