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. 2022 May 1;106(5):1012-1023.
doi: 10.1097/TP.0000000000004075. Epub 2022 Apr 26.

Clinical, Functional, and Mental Health Outcomes in Kidney Transplant Recipients 3 Months After a Diagnosis of COVID-19

Raphaël Duivenvoorden  1 , Priya Vart  2 , Marlies Noordzij  2 , Augusto C Soares Dos Santos Jr  3 , Alex B Zulkarnaev  4 , Casper F M Franssen  2 , Dirk Kuypers  5 , Erol Demir  6 , Hormat Rahimzadeh  7 , Julia Kerschbaum  8 , Kitty J Jager  9 , Kultigin Turkmen  10 , Marc H Hemmelder  11   12 , Marcel Schouten  13 , María Luisa Rodríguez-Ferrero  14 , Marta Crespo  15 , Ron T Gansevoort  2 , Luuk B Hilbrands  1 ; ERACODA Collaborators
Collaborators, Affiliations

Clinical, Functional, and Mental Health Outcomes in Kidney Transplant Recipients 3 Months After a Diagnosis of COVID-19

Raphaël Duivenvoorden et al. Transplantation. .

Abstract

Background: Kidney transplant patients are at high risk for coronavirus disease 2019 (COVID-19)-related mortality. However, limited data are available on longer-term clinical, functional, and mental health outcomes in patients who survive COVID-19.

Methods: We analyzed data from adult kidney transplant patients in the European Renal Association COVID-19 Database who presented with COVID-19 between February 1, 2020, and January 31, 2021.

Results: We included 912 patients with a mean age of 56.7 (±13.7) y. 26.4% were not hospitalized, 57.5% were hospitalized without need for intensive care unit (ICU) admission, and 16.1% were hospitalized and admitted to the ICU. At 3 mo follow-up survival was 82.3% overall, and 98.8%, 84.2%, and 49.0%, respectively, in each group. At 3 mo follow-up biopsy-proven acute rejection, need for renal replacement therapy, and graft failure occurred in the overall group in 0.8%, 2.6%, and 1.8% respectively, and in 2.1%, 10.6%, and 10.6% of ICU-admitted patients, respectively. Of the surviving patients, 83.3% and 94.4% reached their pre-COVID-19 physician-reported functional and mental health status, respectively, within 3 mo. Of patients who had not yet reached their prior functional and mental health status, their treating physicians expected that 79.6% and 80.0%, respectively, still would do so within the coming year. ICU admission was independently associated with a low likelihood to reach prior functional and mental health status.

Conclusions: In kidney transplant recipients alive at 3-mo follow-up, clinical, physician-reported functional, and mental health recovery was good for both nonhospitalized and hospitalized patients. Recovery was, however, less favorable for patients who had been admitted to the ICU.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
Flow diagram of hospitalization, ICU admission, and mortality within 3 mo after presenting with COVID-19. Status of alive patients is status at 3 mo or last known status. COVID-19, coronavirus disease 2019; ICU, intensive care unit.
FIGURE 2.
FIGURE 2.
Kaplan–Meier curves showing cumulative survival probability by hospitalization and ICU admission status. ICU, intensive care unit.
FIGURE 3.
FIGURE 3.
Flow diagram of patient inclusion and results for analysis of graft function–related outcomes and functional and mental health outcomes. Patients analyzed for kidney function status and patients analyzed for functional and mental health outcomes are not totally exclusive study populations. From a total of 450 patients analyzed for functional and mental status, 449 were also analyzed for kidney function status. Thirty-eight other patients had information on kidney function status but not on functional and mental status.
FIGURE 4.
FIGURE 4.
Functional and mental health outcomes among survivors 3 mo after presenting with COVID-19. COVID-19, coronavirus disease 2019.
See this image and copyright information in PMC

References

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