key: cord-0784074-zogxadr9 authors: Malinowska, Agnieszka; Heleniak, Zbigniew; Muchlado, Marta; Ślizień, Zuzanna; Ruszkowski, Jakub; Tylicki, Leszek; Król, Ewa; Dębska-Ślizień, Alicja title: Changes in kidney graft function in COVID-19 convalescents. date: 2022-03-16 journal: Transplant Proc DOI: 10.1016/j.transproceed.2022.03.003 sha: a7aef507de7d681048dee291dc365ef933357b20 doc_id: 784074 cord_uid: zogxadr9 Introduction Kidney transplant recipients (KTR) are at an increased risk of infection with severe respiratory syndrome coronavirus 2 (SARS-CoV-2) with mortality from 13 to over 30%. However, data concerning the influence of COVID-19 on long-term graft function in convalescents is lacking. Material and Methods A longitudinal controlled study was conducted in a group of 1058 KTR. Of 180 patients with COVID-19 in the past, 77 KTR (45 male) at a mean age 50.57±13.37 years, Charlson Comorbidity Index (CCI) of median (interquartile range - IQR) 3(3-5), Fragility Score (FS) of median (IQR) 3(3-3) and minimum 6 months after acute COVID-19 were included. The most common symptoms were: weakness (75.33%), fever (74.03%), cough (51.95%), and loss of appetite (48.05%). 33 of them were hospitalized, no one required invasive ventilation therapy, but 16 required oxygen support. The treatment of COVID19 included antibiotics (38.96%), thromboprophylaxis (25.97%), NSAIDs or paracetamol (25.97%). The aim of the study to evaluate the influence of COVID-19 on graft function at 6 months after recovery. Results The median (IQR) values of serum creatinine 3 months before the onset and 6 months after COVID19 were: 1.25(0.98-1.86) and 1.26(1.03-1.78) mg/dl (non-significant difference); in strata analysis, there were also no differences with regards to patients with higher and lower comorbidity (33). The percentage of patients with FS above 3 increased from 15.58% to 25.97% after 6 months of the COVID-19 infection. That rise points to the necessity of an early start for physiotherapy and the rehabilitation of post-COVID-19 convalescents. Our study has limitations: this is a single-center study with a small sample size. Therefore, our results need to be validated by larger prospective cohort studies. Second, we had no information on graft function during coronavirus infection. Certainly, some cases of acute allograft dysfunction had to occur during the early phase of infection and shortly after. We also cannot eliminate some degree of underreporting of COVID-19 in KTR. Thirdly, as the heaviest limitation, we had to exclude 36 patients from our analysis due to withdrawal of consent and a lack of serum creatinine measurement in our center. The reason for the drop-out of KTR from our observation was mainly caused by the patient's fear before any medical contact during the epidemic. However, since there were no significant differences in age and sex between study population and all patients excluded from our analysis, we believe that the selection bias was unlikely. It seems to be interesting to compare kidney function with non-transplant recipients, with similar degree of comorbidity and frailty as well, who suffered from COVID-19. Additionally, further studies focused on the long-term outcomes of COVID-19 and monitoring of all patients who survived the infection are needed. In conclusion, our analysis reveals that in the group of KTR with a mild course of COVID-19 no negative impact of the infection on graft function was noticed 6 months after recovery. Katz-Greenberg G, Yadav A, Gulati R, Singh P. Outcomes of COVID-19-positive kidney transplant recipients. J Am Soc Nephrol. 2020;31. 14. Basic The kidney and COVID-19 patients -Important considerations COVID-19 impact on the renal system: Pathophysiology and clinical outcomes Thrombotic microangiopathy in a kidney transplant patient after COVID-19 Renal impairment and its impact on clinical outcomes in patients who are critically ill with COVID-19: a multicentre observational study COVID-19 in kidney transplant recipients: A multicenter experience in Istanbul Kidney transplant patients with SARS-CoV-2 infection: The Brescia Renal COVID task force experience COVID-19 and kidney transplantation: Results from the TANGO International Transplant Consortium COVID-19 in solid organ transplant recipients: Initial report from the US epicenter Predictors of humoral response to mrna covid19 vaccines in kidney transplant recipients: A longitudinal study-the covineph project Boosting Humoral Immunity from mRNA COVID-19 Vaccines in Kidney Transplant Recipients A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation Post-COVID-19 sydrome and decrease in healthrelated quality of life in kidney transplant recipients after SARS-CoV-2 infection-a cohort longitudinal study from the north of poland