COVID-19 Disease in Kidney Transplantation Recipients: A Single-Center Study (Experience of Dr. Shariati Hospital)
نویسندگان
1 Department of Radiology, School of Medicine, University of California, San Diego (UCSD), California, USA
2 Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
3 School of Medicine, Islamic Azad University, Tehran, Iran
4 Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
5 Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
6 Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
7 Department of Health Information Technology, Zabol University of Medical Sciences, Zabol, Iran
8 Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
9 Université Aix-Marseille, Institut de Neuro-physiopathologie (INP),UMR 7051, Faculté de Pharmacie,27 Bd Jean Moulin, 13385 Marseille Cedex, France
10 Department of Public Health and Community Medicine, School of Medicine, Tufts University, Massachusetts, USA
11 School of Medicine, Iran University of Medical Sciences, Tehran , Iran
12 Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
13 Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
14 Department of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
15 School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
16 School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
17 Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
18 Department of Health Information Management, Tehran University of Medical Sciences, Tehran, Iran
19 Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
doi
http://dx.doi.org/10.18502/jimc.v5i1.9568چکیده
Background: Coronavirus disease 2019 (COVID-19 disease) is caused by SARS-CoV-2. In December 2019, several outbreaks of severe and life-threatening pneumonia with unknown organism were reported in Wuhan, China and the disease spread rapidly all over the world and caused the biggest pandemic. There was no clear information regarding incidence, morbidity, and mortality rate of COVID-19 disease in kidney transplant recipients or other solid organ transplant recipients. Therefore, we designed a study to evaluate the factors that can have any impact on kidney transplant recipients infected with SARS-Cov2.Methods: Our research was a retrospective cross-sectional study. The study population was all adult kidney transplant recipients (> 18 years old) who were hospitalized due to COVID-19 disease according to national guidelines from 1st March, 2020 to 20th April, 2020 in Shariati Hospital, Tehran, Iran. Demographic data, common clinical complaints, vital signs, types and dose of immunosuppressive drugs, comorbidity diseases, and basic laboratory tests were extracted from the medical records using a data collection form.Results: According to the results of our investigation, mortality rate was 69.2% in kidney transplant recipients who were admitted in our hospital. No one died under the age of 47 years, while no one survived over the age of 58 years. As a result, age can be a reliable predictor of survival rate in kidney transplant recipients with COVID-19 pneumonia. All patients in non- survivors’ group were elderly and needed intubation, mechanical ventilation, and renal replacement.Conclusion: In addition to early referral and early start of appropriate and specific treatments of COVID-19 in patients with kidney transplantation, our general advice, is discontinuation of antimetabolite drugs at admission time, dose reduction of calcineurin inhibitors, and even withdrawal of all immunosuppressive drugs except steroids in critical cases.
