Follow‐up of renal transplant recipients after acute COVID‐19—A prospective cohort single‐center study

Abstract Introduction Although most patients recover within several weeks after acute COVID‐19, some of them develop long‐lasting clinical symptoms. Renal transplant recipients have an increased mortality risk from COVID‐19. We aimed to describe complications occurring after COVID‐19 in this group o...

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Autores principales:	Nikolina Basic‐Jukic, Ivana Juric, Vesna Furic‐Cunko, Lea Katalinic, Josipa Radic, Zrinka Bosnjak, Bojan Jelakovic, Zeljko Kastelan
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	complications long‐COVID‐19 mortality post‐COVID‐19 renal transplantation SARS‐CoV‐2 Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/cf220a8e536a42e4a846d7dd3098128d
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spelling	oai:doaj.org-article:cf220a8e536a42e4a846d7dd3098128d2021-11-12T19:57:15ZFollow‐up of renal transplant recipients after acute COVID‐19—A prospective cohort single‐center study2050-452710.1002/iid3.509https://doaj.org/article/cf220a8e536a42e4a846d7dd3098128d2021-12-01T00:00:00Zhttps://doi.org/10.1002/iid3.509https://doaj.org/toc/2050-4527Abstract Introduction Although most patients recover within several weeks after acute COVID‐19, some of them develop long‐lasting clinical symptoms. Renal transplant recipients have an increased mortality risk from COVID‐19. We aimed to describe complications occurring after COVID‐19 in this group of patients. Methods A prospective single‐center cohort study was conducted at University Hospital Centre Zagreb. Patients with two negative reverse transcriptase‐polymerase chain reaction (RT‐PCR) tests for SARS‐CoV‐2 after COVID‐19 were eligible for further follow‐up at our outpatient clinic. They underwent detailed clinical and laboratory assessments. The primary outcome was the development of complications after COVID‐19. Results Only 11.53% of renal transplant recipients who survived acute COVID‐19 were symptomless and free from new‐onset laboratory abnormalities during the median follow‐up of 64 days (range: 50–76 days). Three patients died from sepsis after discharge from the hospital. In 47 patients (45.2%), clinical complications were present, while 74 patients (71.2%) had one or more laboratory abnormalities. The most common clinical complications included shortness of breath (19.2%), tiredness (11.5%), peripheral neuropathy (7.7%), self‐reported cognitive impairments (5.7%), and dry cough (7.7%). Most common laboratory abnormalities included shortened activated partial thromboplastin time (50%), elevated D‐dimers (36.5%), elevated fibrinogen (30.16%), and hypogammaglobulinemia (24%). Positive RT‐PCR for cytomegalovirus (8.7%), Epstein–Barr virus (26%), or BK virus (16.3%). Multivariate analysis identified the history of diabetes mellitus and eGFR CKD‐EPI as predictors for the development of post‐COVID clinical complications. Six months after acute COVID‐19, elevated D‐dimers persisted with normalization of other laboratory parameters. Twenty‐nine patients were hospitalized, mostly with several concomitant problems. However, initially reported clinical problems gradually improved in the majority of patients. Conclusion Post‐COVID‐19 clinical and laboratory complications are frequent in the renal transplant population, in some of them associated with significant morbidity. All patients recovered from acute COVID‐19 should undergo long‐term monitoring for evaluation and treatment of complications.Nikolina Basic‐JukicIvana JuricVesna Furic‐CunkoLea KatalinicJosipa RadicZrinka BosnjakBojan JelakovicZeljko KastelanWileyarticlecomplicationslong‐COVID‐19mortalitypost‐COVID‐19renal transplantationSARS‐CoV‐2Immunologic diseases. AllergyRC581-607ENImmunity, Inflammation and Disease, Vol 9, Iss 4, Pp 1563-1572 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	complications long‐COVID‐19 mortality post‐COVID‐19 renal transplantation SARS‐CoV‐2 Immunologic diseases. Allergy RC581-607
spellingShingle	complications long‐COVID‐19 mortality post‐COVID‐19 renal transplantation SARS‐CoV‐2 Immunologic diseases. Allergy RC581-607 Nikolina Basic‐Jukic Ivana Juric Vesna Furic‐Cunko Lea Katalinic Josipa Radic Zrinka Bosnjak Bojan Jelakovic Zeljko Kastelan Follow‐up of renal transplant recipients after acute COVID‐19—A prospective cohort single‐center study
description	Abstract Introduction Although most patients recover within several weeks after acute COVID‐19, some of them develop long‐lasting clinical symptoms. Renal transplant recipients have an increased mortality risk from COVID‐19. We aimed to describe complications occurring after COVID‐19 in this group of patients. Methods A prospective single‐center cohort study was conducted at University Hospital Centre Zagreb. Patients with two negative reverse transcriptase‐polymerase chain reaction (RT‐PCR) tests for SARS‐CoV‐2 after COVID‐19 were eligible for further follow‐up at our outpatient clinic. They underwent detailed clinical and laboratory assessments. The primary outcome was the development of complications after COVID‐19. Results Only 11.53% of renal transplant recipients who survived acute COVID‐19 were symptomless and free from new‐onset laboratory abnormalities during the median follow‐up of 64 days (range: 50–76 days). Three patients died from sepsis after discharge from the hospital. In 47 patients (45.2%), clinical complications were present, while 74 patients (71.2%) had one or more laboratory abnormalities. The most common clinical complications included shortness of breath (19.2%), tiredness (11.5%), peripheral neuropathy (7.7%), self‐reported cognitive impairments (5.7%), and dry cough (7.7%). Most common laboratory abnormalities included shortened activated partial thromboplastin time (50%), elevated D‐dimers (36.5%), elevated fibrinogen (30.16%), and hypogammaglobulinemia (24%). Positive RT‐PCR for cytomegalovirus (8.7%), Epstein–Barr virus (26%), or BK virus (16.3%). Multivariate analysis identified the history of diabetes mellitus and eGFR CKD‐EPI as predictors for the development of post‐COVID clinical complications. Six months after acute COVID‐19, elevated D‐dimers persisted with normalization of other laboratory parameters. Twenty‐nine patients were hospitalized, mostly with several concomitant problems. However, initially reported clinical problems gradually improved in the majority of patients. Conclusion Post‐COVID‐19 clinical and laboratory complications are frequent in the renal transplant population, in some of them associated with significant morbidity. All patients recovered from acute COVID‐19 should undergo long‐term monitoring for evaluation and treatment of complications.
format	article
author	Nikolina Basic‐Jukic Ivana Juric Vesna Furic‐Cunko Lea Katalinic Josipa Radic Zrinka Bosnjak Bojan Jelakovic Zeljko Kastelan
author_facet	Nikolina Basic‐Jukic Ivana Juric Vesna Furic‐Cunko Lea Katalinic Josipa Radic Zrinka Bosnjak Bojan Jelakovic Zeljko Kastelan
author_sort	Nikolina Basic‐Jukic
title	Follow‐up of renal transplant recipients after acute COVID‐19—A prospective cohort single‐center study
title_short	Follow‐up of renal transplant recipients after acute COVID‐19—A prospective cohort single‐center study
title_full	Follow‐up of renal transplant recipients after acute COVID‐19—A prospective cohort single‐center study
title_fullStr	Follow‐up of renal transplant recipients after acute COVID‐19—A prospective cohort single‐center study
title_full_unstemmed	Follow‐up of renal transplant recipients after acute COVID‐19—A prospective cohort single‐center study
title_sort	follow‐up of renal transplant recipients after acute covid‐19—a prospective cohort single‐center study
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/cf220a8e536a42e4a846d7dd3098128d
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Follow‐up of renal transplant recipients after acute COVID‐19—A prospective cohort single‐center study

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