Follow‐up of renal transplant recipients after acute COVID‐19 — A prospective cohort single‐center study

Scientific paper - Original scientific paper

• Author: Nikolina Bašić‐Jukić
• Author: Ivana Juric
• Author: Vesna Furić‐Čunko
• Author: Lea Katalinić
• Author: Josipa Radić
• Author: Zrinka Bošnjak; MBZ: 319631
• Author: Bojan Jelaković
• Author: Željko Kaštelan
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Author's institution: University of Zagreb; School of Medicine; (Department of Urology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Urology

Abstract (english)

Introduction: Although most patients recover within several weeks after acute COVID-19, some of them develop long-lasting clinical symptoms. Renal transplant recipients have an increased mortality risk from COVID-19. We aimed to describe complications occurring after COVID-19 in this group of patients.
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Methods: A prospective single-center cohort study was conducted at University Hospital Centre Zagreb. Patients with two negative reverse transcriptase-polymerase chain reaction (RT-PCR) tests for SARS-CoV-2 after COVID-19 were eligible for further follow-up at our outpatient clinic. They underwent detailed clinical and laboratory assessments. The primary outcome was the development of complications after COVID-19.
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Results: Only 11.53% of renal transplant recipients who survived acute COVID-19 were symptomless and free from new-onset laboratory abnormalities during the median follow-up of 64 days (range: 50-76 days). Three patients died from sepsis after discharge from the hospital. In 47 patients (45.2%), clinical complications were present, while 74 patients (71.2%) had one or more laboratory abnormalities. The most common clinical complications included shortness of breath (19.2%), tiredness (11.5%), peripheral neuropathy (7.7%), self-reported cognitive impairments (5.7%), and dry cough (7.7%). Most common laboratory abnormalities included shortened activated partial thromboplastin time (50%), elevated D-dimers (36.5%), elevated fibrinogen (30.16%), and hypogammaglobulinemia (24%). Positive RT-PCR for cytomegalovirus (8.7%), Epstein-Barr virus (26%), or BK virus (16.3%). Multivariate analysis identified the history of diabetes mellitus and eGFR CKD-EPI as predictors for the development of post-COVID clinical complications. Six months after acute COVID-19, elevated D-dimers persisted with normalization of other laboratory parameters. Twenty-nine patients were hospitalized, mostly with several concomitant problems. However, initially reported clinical problems gradually improved in the majority of patients.
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Conclusion: Post-COVID-19 clinical and laboratory complications are frequent in the renal transplant population, in some of them associated with significant morbidity. All patients recovered from acute COVID-19 should undergo long-term monitoring for evaluation and treatment of complications.

• Keywords (english): COVID-19; Cohort Studies; Epstein-Barr Virus Infections; Follow-Up Studies; Herpesvirus 4, Human; Humans; Kidney Transplantation / adverse effects; Prospective Studies; SARS-CoV-2
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Immunity, Inflammation and Disease
• Numbering: vol. 9, no. 4, pp. 1563-1572
• p-ISSN: 2050-4527
• e-ISSN: 2050-4527
• DOI: https://doi.org/10.1002/iid3.509
• URN:NBN: urn:nbn:hr:105:032517
• Publication: 2021-11
• Document URL: https://onlinelibrary.wiley.com/doi/10.1002/iid3.509
• Type of resource: Text
• Access conditions: Open access
• Created on: 2022-05-17 09:19:48