Migratory pattern of the coronavirus disease 2019 and high fatality rates among kidney transplant recipients: report from the Brazilian Multicenter Cohort Study

Abstract

Introduction: The unprecedented coronavirus disease 2019 (COVID-19) pandemic has affected kidney transplant (KT) recipients, with worldwide fatality rates around 25%. Considering the well-known Brazilian socio-demographic disparities, this report describes for the first time the main outcomes of COVID-19 in KT recipients according to Brazilian geographic regions. Methods: This multicenter national retrospective analysis included data from KT recipients with confirmed COVID-19 between March and November 2020. Results: Thirty-five of the 81 centers (57% of KT activity in Brazil) reported 1,680 patients with COVID-19. The Northeast was the first to reach the peak in the number of infections. The Southeast, due to its population density, contributed with the largest number of patients. Patients had a median age of 52 years, 76% had hypertension and 34% diabetes, 75% were recipients of a deceased donor, and the time interval between diagnosis and transplantation was 5.9 years. In 53% of patients, immunosuppression was adjusted, and clinical support varied according to geographic region. Hospitalization was required for 65% of the patients, 35% of them needed intensive care, 25% mechanical ventilation, and 23% renal replacement therapy. The 90-day overall fatality was 21%, being 23% in the Southeast, 16% in the Northeast, and 19% in the Central-west and South regions. Conclusion: The migratory pattern of the pandemic among KT recipients followed that of the general population and the outcomes were influenced by regional features. COVID-19 in KT recipients was associated with high utilization of health-care resources and higher fatality rates than those reported in the general population.

Impacto na Fila de Espera dos Transplantes de Órgãos Sólidos Durante a Pandemia de Covid-19: Uma Revisão Integrativa

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One-year impact of COVID-19 pandemic on renal replacement therapy and kidney transplantation in a tertiary center in Southern Brazil

“…These factors increase exposure and pose a challenge in maintaining social distancing. Also, kidney transplant recipients (KTR) are a high-risk population for COVID19 complications and death 6 , 7 , mainly due to many comorbidities such as hypertension, diabetes, cardiac conditions, and the necessary state of immunosuppression and also because they are affected by metabolic and inflammatory conditions 6 , 8 .…”

Impacto de um ano da Pandemia COVID 19 na terapia renal substitutiva e no transplante renal em centro terciário no Sul do Brasil

“…Estes fatores aumentam a exposição e representam um desafio na manutenção do distanciamento social. Além disso, os receptores de transplante renal (RTR) são uma população de alto risco para complicações e óbito por COVID-19 6,7 , principalmente devido a muitas comorbidades como hipertensão, diabetes, condições cardíacas e o estado necessário de imunossupressão, e também porque são afetados por condições metabólicas e inflamatórias 6,8 .…”