Prognosis of COVID-19 in Renal Transplantation Patients
COVID-19 in Renal Transplantation
DOI:
https://doi.org/10.71350/ajaic.2Keywords:
COVID-19, Renal transplantation, Intensive care unit, Mortality, Interleukin-6Abstract
Background: Renal transplant recipients are particularly vulnerable to severe viral infections due to chronic immunosuppression and a high burden of comorbidities. Coronavirus disease 2019 (COVID-19) has been associated with poor outcomes in solid organ transplant recipients, especially among those requiring intensive care unit (ICU) admission. However, data regarding prognostic factors associated with mortality in critically ill renal transplant patients with COVID-19 remain limited.
Materials and Methods: This retrospective, single-center cohort study included adult renal transplant recipients admitted to the ICU with confirmed COVID-19. Demographic characteristics, comorbid conditions, and laboratory parameters obtained at ICU admission were analyzed. The primary outcome was in-hospital survival status. Secondary outcomes included the requirement for invasive mechanical ventilation, vasopressor support, renal replacement therapy, development of secondary infections, and length of ICU stay.
Results: Seventeen renal transplant recipients with severe COVID-19 were included. Non-survivors required invasive mechanical ventilation more frequently than survivors (85.7% vs. 20.0%, p=0.015) and had a higher requirement for vasopressor support (p=0.004). In addition, serum interleukin-6 (IL-6) levels measured at ICU admission were significantly higher in non-survivors compared with survivors (p=0.014). Baseline demographic characteristics, comorbidities, and most conventional laboratory parameters did not differ significantly between the groups.
Conclusion: In critically ill renal transplant recipients with COVID-19, the need for advanced organ support and elevated IL-6 levels at ICU admission were significantly associated with in-hospital mortality. Conventional clinical characteristics and routine laboratory markers demonstrated limited discriminative value in this high-risk population. Although the acute phase of the COVID-19 pandemic has passed, these findings provide clinically relevant insights into the vulnerability of renal transplant recipients during severe viral infections and may inform future risk assessment and preparedness strategies.
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