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. 2022 Sep 13.
doi: 10.1016/j.nefro.2022.09.003. Online ahead of print.

Impact of immunosuppression regimen on COVID-19 mortality in kidney transplant recipients: Analysis from a Colombian transplantation centers registry

[Article in Spanish]
Montero Camilo  1   2   3   4 , Torres Rodolfo  1   2   3 , Benavidez Carlos  5 , Garcia Paola  6 , Jimenez Sandra  7 , Yomayusa Nancy  2 , Gayon Diana  1 , Perez Jorge  1 , Rosselli Diego  8 , Restrepo Hector  9 , Alvarez Carlos  10
Affiliations

Impact of immunosuppression regimen on COVID-19 mortality in kidney transplant recipients: Analysis from a Colombian transplantation centers registry

[Article in Spanish]
Montero Camilo et al. Nefrologia. .

Abstract

Background: The impact of immunosuppression in solid organ transplant recipients with SARS-CoV-2 infection is unknown. The knowledge about the behavior of different immunosuppression schemes in clinical outcomes is scarce. This study aimed to determine the risk of death in kidney transplant recipients with COVID-19 under two different schemes of immunosuppression.

Methods: We describe our experience in kidney transplant recipients with SARS-CoV-2 infection in seven transplant centers during the first year of the pandemic before starting the vaccination programs in the city of Bogotá. Demographic characteristics, clinical presentation, immunosuppression schemes at presentation, and global treatment strategies were compared between recovered and dead patients; survival analysis was carried out between calcineurin inhibitors based regimen and free calcineurin inhibitors regimen.

Results: Among 165 confirmed cases, 28 died (17%); the risk factors for mortality identified in univariate analysis were age older than 60 years (p = .003) diabetes (p = .001), immunosuppression based on calcineurin inhibitors (CNI) (p = .025) and patients receiving steroids (p = .041). In multivariable analysis, hypoxemia (p = .000) and calcineurin inhibitors regimen (p = .002) were predictors of death. Survival analysis showed increased mortality risk in patients receiving CNI based immunosuppression regimen vs. CNI free regimens mortality rates were, respectively, 21.7% and 8.5% (p = .036).

Conclusions: Our results suggest that the calcineurin inhibitors probably do not provide greater protection compared to calcineurin inhibitor free schemes being necessary to carry out analyzes that allow us to evaluate the outcomes with different immunosuppression schemes in solid organ transplant recipients with SARS-CoV-2 infection.

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Figures

Fig. 1
Fig. 1
Survival function for death according to CNI based immunosuppression regimen and CNI free immunosuppression regimen at the time of SARS-CoV-2 infection diagnosis.
See this image and copyright information in PMC

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