How COVID-19 crisis influenced kidney transplant recipients in Slovakia.

ZILINSKA, Zuzana; CHRASTINA, Martin; ZITNAKOVA, Marcela; LACKOVA, Eva; CELLAR, Marcel; BENA, Luboslav; BALTESOVA, Tatiana; ROSENBERGER, Jaroslav; GRANAK, Karol; VNUCAK, Matej; DEDINSKA, Ivana; BREZA, Jan

OBJECTIVES: The aim of our analysis was to evaluate the impact of the COVID-19 pandemic on the procurement program and kidney transplantation in Slovakia and to identify the risk factors for a severe course of COVID-19 disease, as well as the risk factors for COVID-19 fatalities, with the focus on the parameters preceding the infection. We compared morbidity and mortality from COVID-19 before and after the spread of the alpha variant of the virus and the same among transplant (KTRs) and haemodialysis patients in Slovakia. METHODS: 305 KTRs (68.8 % males) with confirmed SARS-CoV-2 positivity were included in the multicentric retrospective analysis. The patients were split into subgroups based on the time of falling ill and their clinical course. RESULTS: The procurement program and kidney transplants in Slovakia dropped in the observed period by 28.6 % (p<0.0001) and by 33.5 % (p<0.0001) respectively. Age over 59 years (p=0.0088) and diabetes mellitus (p=0.0106) were identified as independent risk factors for severe course of the disease. Risk factors for death were the age over 59 years (p=0.0003) and graft dysfunction with CKD-EPI<0.5 mL/s (p=0.0029). The prevalence of the alpha variant in Slovakia was associated with a severe course in KTRs treated with corticoids (p=0.0273) and in graft dysfunction with CKD-EPI<0.5 mL/s (p=0.0076); the risk of death was higher in KTRs over 59 years (p=0.0173) and again with CKD-EPI<0.5 mL/s (p=0.0393). KTRs had a 3.7 times lower risk of infection compared to the haemodialysis patients (p<0.0001), with mortality of 9.8 % vs 30 % (p<0.0001). CONCLUSION: The procurement and transplant program is sustainable even during a pandemic, provided that measures are set up quickly. Morbidity and mortality from COVID-19 in KTRs was comparable to the situation in EU countries. Patients in the haemodialysis program had a worse prognosis (Tab. 5, Fig. 1, Ref. 21). Text in PDF www.elis.sk

SLOVAKIA; COVID-19 pandemic; KIDNEY transplantation; COVID-19; HEMODIALYSIS patients; DEATH rate; BK virus

Bratislava Medical Journal / Bratislavské Lekárske Listy, 2022, Vol 123, Issue 5, p315

0006-9248

Academic Journal

10.4149/BLL_2022_049