COVID-19 Infected Kidney Transplant Patients Outpatient Management—A Single-center Experience With a Hospital-at-home Program

Abstract

Inclusion and exclusion criteria Inclusion criteriaRecipient of minimally 2 doses of a COVID-19 vaccine Normal mental state Stable vital signs (defined as systolic blood pressure 100-160 mmHg, heart rate 60-100 beats/min, pulse oximetry saturations >94% on room air) Able to self-care in isolation (does not require assistance with activities of daily living) Competent to participate in telemedicine Exclusion criteria Kidney transplantation <6 mo Recent treatment/augmentation of immunosuppression for rejection <3 mo Significant pulmonary disease, eg, chronic obstructive pulmonary disease Other medical concerns of increased adverse outcome if home-based recovery Significant abnormalities on preenrollment screening tests a Ongoing chest/abdominal pain Dyspnea Severe vomiting or diarrhea where absorption of drugs may be impaired Oliguria or anuria Vulnerable uninfected household people (eg, ≥ 80 y, pregnant) and/or inability for self-isolation in the home Patient declines enrollment into HaH program a Patients underwent preenrollment screening tests of complete blood count, kidney function test, and C-reactive protein levels. A confirmatory polymerase chain reaction testing for SARS-CoV-2 and RBD levels was performed at time of preenrollment screening tests.

An outpatient model of care for COVID‐19 infected kidney transplant patients – The hospital‐at‐home

“…Prior studies of HaH programmes in non‐KTR populations have shown reductions in mortality, readmission rates and cost with increase in patient and carer satisfaction 15 . We previously reported early data from the first 2 months of the COVID‐19 KTR in HaH which showed encouraging results 16 . In this paper, we describe the sustainability and outcomes of this collaboration on extended follow‐up.…”

“…However, the tenet of early review and therapeutics for 15 We previously reported early data from the first 2 months of the COVID-19 KTR in HaH which showed encouraging results. 16 In this paper, we describe the sustainability and outcomes of this collaboration on extended follow-up.…”

Safely navigating kidney transplantation during the COVID-19 pandemic: the Singapore General Hospital’s experience

“…KTRs who contracted COVID-19 infection were triaged virtually via video consultation with transplant physicians. Depending on their clinical status, they were either enrolled in a remotely monitored home recovery program or admitted for inpatient care at our transplant center [ 18 ]. However, patients who were critically ill were taken to their nearest hospitals, which may not have had transplant services.…”