Moderate and severe infection with SARS-CoV-2, the novel coronavirus that causes COVID-19, in kidney transplant recipients (KTRs) is associated with a greater decline in kidney allograft function at 90 days after infection compared with mild infection, according to study data presented at the virtual 2021 American Transplant Congress.
KTRs are particularly susceptible to SARS-CoV-2 infection and an adverse clinical course from the infection because of their immunosuppressed state and increased propensity for kidney injury, explained lead investigator Joseph R. Leventhal, MD, PhD, director of the kidney and pancreas transplant programs at Northwestern University in Chicago, Illinois.
“The primary purpose of this study was to determine how this infection with [SARS-CoV-2] might impact long-term renal transplant function,” Dr Leventhal told Renal & Urology News. “And what we found was that there was an association between a severe form of SARS-CoV-2 infection and a greater risk of acute kidney injury and a decline in kidney function as assessed at 90 days post-infection compared to people who had milder forms of the disease.”
Dr Leventhal and colleagues conducted a retrospective, single-center study that included 53 KTRs at Northwestern Memorial Hospital who had a positive SARS-CoV-2 polymerase chain reaction test result. The group included 11 patients with a mild infection, 29 with a moderate infection, and 13 with a severe infection. Patients’ disease severity was ranked according to the World Health Organization Ordinal Scale for SARS-CoV-2 Clinical Improvement.
Patients with moderate and severe infection experienced a 17.50% and 23.16% decrease in estimated glomerular filtration rate (eGFR), respectively, from baseline (prior to the positive test) to 90 days after the positive test. Patients with a mild infection experienced a 1.76% increase in eGFR.
The patients with moderate and severe infection also had a significantly increased risk for acute kidney injury.
These results highlight the importance of closely monitoring renal allograft function in KTRs with SARS-CoV-2 infection, Dr Leventhal’s team concluded.
Nahi S, Shetty A, Tanna S, Leventhal J. Impact of SARS-CoV-2 infection on graft function in kidney transplant recipients: an academic single center experience. Presented at: ATC 2021 virtual meeting held June 4-9, 2021. Abstract 468.