COVID-19 in renal transplant patients, on the waiting list and under evaluation for transplantation. Experience in a public hospital in Argentina

Abstract

Objectives: Assess frequency of swabbing, positive and lethality rate cases of SARS-CoV-2 in transplant patients on the waiting list or evaluation in a Public Hospital of Argentina. Methods: A retrospective analysis was carried out of the patients in the unit (transplanted, on the waiting list or under evaluation for transplantation) until September 30, 2020. Each patient was searched individually in the SINTRA, in databases of patients of a transplant unit and in the SISA system, to find: swabbing, percentage of tests positivity, general mortality and that related to SARS-CoV-2. Age, sex, time on dialysis, diabetic condition, hypertension and chronic obstructive pulmonary disease were considered. Statistical analysis was performed using Student, Mann Whitney and Chi square as appropriate. Results: During 2020, a total of 1,513 patients were under follow-up in the Kidney Transplant Unit, including kidney transplants under follow-up (n=515), patients on the renal waiting list (n=413) and patients under evaluation for transplantation (n=585). A total of 103 positive cases of COVID-19 were registered, out of 477 swabs performed (positivity of 32.51%). The overall case fatality rate was of the 21.88%, varying according to the patient was on the waiting list (22.73%) in transplant evaluation (30%) or transplanted (35.48%). These differences did not reach statistical significance. Conclusions: A descriptive analysis of the effects of the pandemic on our population is presented. It is important to note that our center cares for a high percentage of low-income patients and a large geographic area, so the results may have been biased by these characteristics. In our transplanted population, a 10-fold increase in mortality observed in the general population was observed. The presence of a higher degree of immunosuppression and risk factors (diabetes, age, hypertension) could explain what was observed.