Retrospective analysis of COVID-19 in kidney transplant recipients in Azerbaijan: single-center experience.

Private medical center "Medservice"

Ismayılov H., Hasanova Z., Babayev F.

Keywords: Coronavirus, Kidney transplant, program hemodialysis, COVID-19

Introduction:

Kidney transplant recipients with COVID-19 are at high risk of developing critical condition due to long-term immunosuppression as well as comorbidities.

Thousands of patients with chronic and acute renal failure have received hemodialysis in the private medical center "Medservice" in Baku (Azerbaijan) since 2000, 460 patients have been under nephrological observation after kidney transplantation. During the period from January 2020 to February 2022 we examined 75 kidney transplant recipients with a confirmed diagnosis of COVID-19.

Methods:

We conducted a retrospective analysis of kidney transplant recipients diagnosed with COVID-19 (PCR with nasal and pharyngeal swabs) and referred to the private medical center "Medservice" from January 2020 to February 2022.

Results:

Among 75 patients with PCR-confirmed diagnosis of Covid-19 44 were males (58.6%), 31 were females (41.4%). The average age was 46 years, the average body weight was 70 kilograms. The most common symptoms were fever, cough, shortness of breath, decreased oxygen saturation. It should be noted that from July to August 2021, patients had gastrointestinal disorders as a main symptom. The symptoms and the course of the disease suggest presence of the delta strain of SARS-Co2, although we did not have appropriate laboratory equipment to confirm the suggestion. With regard to laboratory tests results, serum C-reactive protein (CRP) level was elevated in 67 patients (89.3%) and remained normal in only 7 patients (9.3%). Serum D-dimer and ferritin levels were elevated in 61 patients (81.3%). According to TTS (World Association of Transplantologists) and TOND (Turkish Organ Transplant Association) protocols, immunosuppressive treatment was modified in 35 (46.6%) patients the following way: antimetabolites treatment was interrupted, dose of calcineurin inhibitors was reduced by 50% or treatment was interrupted and replaced with corticosteroids.

Conclusion:

It can be noted that in patients of the private medical center "Medservice" - recipients of kidney transplants, fever was the most often observed initial symptom, and the abdominal form of coronavirus infection was less common. In most patients, the levels of C-reactive protein, ferritin, D-dimer exceeded normal values.

The study also showed that the number of deaths has recently decreased as a result of improved Covid control measures — vaccination and treatment protocols.