Division of Nephrology, Department of Internal Medicine, Giresun Faculty of Medicine, Giresun University, Giresun, Turkey.
Division of Nephrology, Department of Internal Medicine, Giresun Faculty of Medicine, Giresun University, Giresun, Turkey.
Transplant Proc. 2022 Jul-Aug;54(6):1424-1428. doi: 10.1016/j.transproceed.2022.04.014. Epub 2022 Apr 11.
Kidney transplant recipients appear to be particularly high risk for critical COVID-19 illness owing to chronic immunosuppression and coexisting conditions. The aim of this study is to present the clinical characteristics and outcomes of our hospital's kidney transplant recipients who were hospitalized due to COVID-19 infection.
In our retrospective observational study of COVID-19 PCR-positive patients, 31 of them were hospitalized with COVID-19 pneumonia and they were evaluated using demographics, laboratory data, treatment, and outcome. The prognostic nutritional index (PNI), which is calculated using the serum albumin concentration and total lymphocytic count, was also evaluated. The baseline immunosuppressive therapy of patients at the time of admission and the treatments they received during their hospitalization were recorded. All patients were treated with favipiravir.
Of the 31 renal transplant patients with COVID-19 pneumonia, 20 were male and the mean age was 52.7 ± 13.4. Nine (29%) of the patients died. All patients were treated with favipiravir for 5 days; laboratory tests were recorded before and after treatment. The mean PNI of the patients who survived was higher than the patients who died.
The 9 patients who died had lower PNI and higher neutrophil-to-lymphocyte ratio (NLR), creatinine, l-lactate dehydrogenase (LDH), ferritin, and C-reactive protein (CRP) levels. Hospitalized kidney transplant recipients with COVID-19 have higher rates of mortality. The PNI exhibited good predictive performance and may be a useful clinical marker that can be used for estimating survival in COVID-19 patients.
由于慢性免疫抑制和并存疾病，肾移植受者似乎特别容易发生 COVID-19 重症疾病。本研究旨在介绍我院因 COVID-19 感染住院的肾移植受者的临床特征和结局。
在我们对 COVID-19 PCR 阳性患者的回顾性观察性研究中，其中 31 例因 COVID-19 肺炎住院，并对其进行了人口统计学、实验室数据、治疗和结局评估。还评估了预后营养指数（PNI），它是通过血清白蛋白浓度和总淋巴细胞计数计算得出的。记录了患者入院时的基线免疫抑制治疗以及他们在住院期间接受的治疗。所有患者均接受了法匹拉韦治疗。
31 例 COVID-19 肺炎肾移植患者中，男性 20 例，平均年龄 52.7 ± 13.4 岁。9 例（29%）患者死亡。所有患者均接受法匹拉韦治疗 5 天；记录了治疗前后的实验室检查。存活患者的平均 PNI 高于死亡患者。
9 例死亡患者的 PNI 较低，中性粒细胞与淋巴细胞比值（NLR）、肌酐、l-乳酸脱氢酶（LDH）、铁蛋白和 C 反应蛋白（CRP）水平较高。COVID-19 住院肾移植受者死亡率较高。PNI 表现出良好的预测性能，可能是一种有用的临床标志物，可用于估计 COVID-19 患者的生存率。
