Comparison COVID ۱۹ manifestations between kidney and liver transplantation

Background and Aim : Although transplant recipients are at high risk for severe Coronavirus disease-۲۰۱۹ (COVID-۱۹), there is a dearth of research on the presentations and outcomes of the disease in these patients. This study aimed to compare the presentations and outcomes of liver and kidney transplant recipients who were infected with COVID-۱۹ in the Iranian population.Methods : This cross-sectional study was conducted at Imam Reza and Montaserieh Hospitals affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, between ۲۰۲۰ and ۲۰۲۱. In general, ۵۲ patients were selected and divided into two groups of the kidney (n=۲۸) and liver (n=۲۴) transplantation. Demographic characteristics of the patients, including age, gender, medical history, time interval since the transplantation, common symptoms of COVID-۱۹, clinical presentation, laboratory tests, COVID-۱۹ medications, immunosuppressive agents, chest symptoms, severity of infection based on chest computed tomography scan, and outcome were recorded in a checklist. Data were compared between the two groups, and the relationship among various variables was assessed in this study Results : In general, severe COVID-۱۹ infection was reported in ۶۱% of the patients. Except for one case, other recipients were in the late phase of post-transplantation. There was no significant difference between the two groups in terms of symptoms, except for cough (χ۲=۸.۰۹; P=۰.۰۰۴), clinical condition, and laboratory symptoms, except for creatinine (Z=۱۴; P<۰.۰۰۵), alkaline phosphatase (Z=۴.۵۵; P=۰.۰۳), total bilirubin (Z=۸.۹۳; P=۰.۰۳), and partial thromboplastin time (Z=۵.۹۷; P=۰.۰۱). Higher D-dimer (t=-۲.۱۳; P=۰.۰۴), lymphocyte count (t=-۳.۹۸; P=۰.۰۰۱), and total lymphocyte count (t=۲.۶۲; P=۰.۰۱) were correlated with the severity of COVID-۱۹ in the liver transplant recipients. The most common medications for the treatment of COVID-۱۹ included Hydroxychloroquine (۶۳.۵%), Azithromycin (۴۸.۱%), and Remdesivir (۲۳.۱%) in descending order. There was no relationship between the outcome and the use of immunosuppressive medications (P>۰.۰۵). All patients with kidney transplantation survived, while two cases in the liver transplantation group failed to survive (χ۲=۲.۴۲; P=۰.۱۱). Conclusion : In summary, severe acute respiratory syndrome coronavirus ۲ infections were reported in almost all liver and kidney transplant recipients. Furthermore, the mortality rate was higher in the liver transplant recipients, compared to the patients who underwent kidney transplantation. No relationship was reported between the severity or mortality and immunosuppressive agents.

کلیدواژه ها:

COVID‐۱۹ ، Immunosuppressive ، Mortality ، Transplantation