Post-COVID-19 Sydrome and Decrease in Health-Related Quality of Life in Kidney Transplant Recipients after SARS-COV-2 Infection—A Cohort Longitudinal Study from the North of Poland

Abstract

Introduction: Patients after SARS-CoV-2 infection frequently face “Post-COVID-19 Syndrome”, defined by symptoms that develop during or after COVID-19, continue for more than 12 weeks, and are not explained by an alternative diagnosis. We aimed to evaluate the presence of post-COVID-19 syndrome and its predictors in kidney transplant recipients (KTR) 6 months after the disease. Materials and Methods: A total of 67 KTR (38 m) with a mean age of 53.6 ± 14 years, 7.3 ± 6.4 years post-transplant were included in the cohort longitudinal study. Thirty-nine (58.2%) of them were hospitalized, but not one required invasive ventilation therapy. They were interviewed 6 months after being infected, with a series of standardized questionnaires: a self-reported symptoms questionnaire, the modified British Medical Research Council (mMRC) dyspnea scale, EQ-5D-5L questionnaire, and EQ-VAS scale. Results: Post-COVID-19 syndrome was diagnosed in 70.1% of KTR and 26.9% of them reported at least three persistent symptoms. The most common symptoms were fatigue (43.3%), hair loss (31.3%), memory impairment (11.9%), muscle aches, and headaches (11.9%). Dyspnea with an mMRC scale grade of at least 1 was reported by 34.3% patients vs. 14.9% before infection; 47.8% stated that they still feel worse than before the disease. Mean EQ-VAS scores were 64.83 vs. 73.34 before infection. The persistent symptoms are more frequent in older patients and those with greater comorbidity. Conclusions: Persistent symptoms of post-COVID-19 syndrome are present in the majority of KTR, which highlights the need for long-term follow-up as well as diagnostic and rehabilitation programs.

Long‐lasting clinical symptoms 6 months after COVID-19 infection in the French national cohort of patients on dialysis

“…The most common symptom in our patients was weight or muscle loss (53%), consequences that have seldom been explored in other studies. As in other studies, extreme fatigue and weakness was frequently observed: 32% in our dialysis patients versus 61% in the Gdansk hemodialysis population [ 6 ] or 43% in the Gdansk transplanted population [ 5 ], and 39% to 73% in a systematic review [ 1 ]. Breathlessness is often recorded in the general population (39–74%) [ 1 ] but is less common in dialysis patients: 15% in our study and 34% in the Gdansk study.…”

“…In this study, diabetes and estimated glomerular filtration rate predicted the development of post–COVID-19 clinical complications. In another study of 67 kidney transplant patients, post-COVID syndrome was diagnosed in 70% at 6 months, and 26% reported at least 3 persistent symptoms [ 5 ]. In this study, persistent symptoms were more frequent in older patients and in those with more comorbidities.…”

“…Some studies included more specific populations such as transplanted patients [ 4 , 5 ] or patients on dialysis [ 6 , 7 ]. In fact, SARS-Cov-2 infection is particularly dangerous for these patients because they are more vulnerable owing to their multiple pathologies associated with poor prognosis during COVID-19.…”

COVID-19 in renal replacement therapy patients: an overview of current data and future challenges

“…Based on a meta-analysis of 15,244 hospitalized and 9,011 outpatients with COVID-19, it has been calculated that at least one persistent disease symptom persists 90 days after the onset of the disease in more than 45% of patients [54]. Studies in patients treated with renal replacement therapy are sparse in this respect, but indicate that six months after the disease, the percentage of patients with Post-Covid syndrome may affect as much as 81% of HD patients and 71% of KTR [55,56].…”

“…What distinguishes patients undergoing renal replacement therapy from the general population is the long-lasting feeling of heart palpitations in HD patients, as well as increased hair loss in KTR. Importantly, persistent symptoms significantly translate into a deteriorating quality of life [55,56]. However, one should approach the published reports on the Post-Covid syndrome with some caution.…”