COVID-19 in kidney transplant recipients; a DALMATIAN single-center experience

Introduction We aimed to explore COVID-19 severity, complications, and outcome predictors in the Dalmatian population of kidney transplant recipients (KTRs). Methods KTRs confirmed with acute COVID-19 infection until May 2021 were included and followed up for 6 months. Results Out of 50 KTRs average aged 63 years, 36 (72%) were men. Nine (18%) KTRs had no pulmonary infiltration, and twenty-nine (58%) did not require oxygen supplementation. Bilateral pulmonary infiltrates had 29 (58%) while high-flow nasal cannula or mechanical ventilation required 8 (16%) KTRs. The mortality rate was 16%. Acute kidney injury developed in 18 (36%), and acute renal replacement therapy required 2 (4%) KTRs. Nine (18%) KTRs were subsequently rehospitalized. Chronic COVID-19 syndrome reported 23 (58%) KTRs. Conclusions D-dimers were found to be the key prognostic factor of clinical complications, emphasizing the importance of underlying thrombotic microangiopathy. Optimal immunosuppressant adjusting in KTRs with acute COVID-19 infection remains to be clarified.