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COVID-19 Ricochets on Kidney Transplant and Hemodialysis Patients

Year 2023, , 309 - 315, 30.06.2023
https://doi.org/10.54005/geneltip.1251579

Abstract

Background/Aims: An impaired immune response affects Coronavirus 2019 (COVID-19) disease progression. Immunities of both hemodialysis (HD) and Kidney Transplant (KTx) patients have already been suppressed. This study evaluated the prognostic laboratory results in HD and KTx patients with COVID-19.
Methods: This retrospective, case-control study was conducted with PCR (+) COVID-19 HD and KTx patients and a control group. All patients were divided into two subgroups according to disease severity. Patients' demographic records and laboratory results were obtained from the follow-up files.
Results: A total of 30 HD, 20 KTx patients, and 40 control groups were involved in the study. Gender and hospitalization duration did not differ between the groups. There was a 10% mortality rate in the KTx group and 27% in the HD group. Lung involvement in Computed Tomography (CT) was higher in HD patients (47%) than in KTx (25%). In subgroup evaluations, the most prominent laboratory values were fibrinogen in HD patients and LDH and Ferritin in KTx patients in determining disease severity.
Conclusions: Early hospitalization and treatment implementations will be associated with a good prognosis in HD and KTx patients since CT and laboratory results are not predictive in these groups of patients during the COVID-19 pandemic.

Supporting Institution

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References

  • Mahase E. Covid-19: WHO declares pandemic because of "alarming levels" of spread, severity, and inaction. BMJ 2020;368:m1036
  • WHO (2022) Coronavirus Disease (COVID-19) Dashboard. https://covid19.who.int/. Accessed 19 April 2022
  • Weiss P, Murdoch DR. Clinical course and mortality risk of severe COVID-19. Lancet 2020;395(10229):1014-1015
  • Pascarella G, Strumia A, Piliego C, Bruno F, Del Buono R, Costa F, et al. COVID-19 diagnosis and management: a comprehensive review. J Intern Med 2020;288(2):192-206
  • Alberici F, Delbarba E, Manenti C, Econimo L, Valerio F, Pola A, et al. A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia. Kidney Int 2020;97(6):1083-1088
  • W. Guan, Z. Ni, Yu Hu, W. Liang, C. Ou, J. He, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020;382(18):1708-1720
  • Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020;323(11):1061-1069
  • Jiang F, Deng L, Zhang L, Cai Y, Cheung CW, Xia Z. Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19). J Gen Intern Med 2020;35(5):1545-1549
  • Azzi Y, Bartash R, Scalea J, Loarte-Campos P, Akalin E. COVID-19 and Solid Organ Transplantation: A Review Article. Transplantation 2021;105(1):37-55
  • Vaziri ND, Pahl MV, Crum A, Norris K. Effect of uremia on structure and function of immune system. J Ren Nutr 2012;22(1):149-56
  • Lee IC, Huo TI, Huang YH. Gastrointestinal and liver manifestations in patients with COVID-19. J Chin Med Assoc. 2020;83(6):521-523
  • Mao R, Qiu Y, He JS, Tan JY, Li XH, Liang J, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2020;5(7):667-678
  • Dashti-Khavidaki S, Khalili H, Nourian A. Pharmacotherapy Considerations in CKD Patients With COVID-19, A Narrative Review. Iran J Kidney Dis 2020;14(4):247-255.
  • Coulter CV. The role of the suspicious renal pharmacist in identifying unusual adverse drug reactions-why this is not a small problem. Int J Clin Pharm 2018;40(4):775-777
  • https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum/
  • Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395(10223):507-13.
  • Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. J Intensive Care 2020;8:36.
  • Tang HM, Tang HL. Anastasis: recovery from the brink of cell death. R Soc Open Sci 2018;5(9):180442.
  • Łabuś A, Niemczyk M, Kulesza A, Fliszkiewicz M, Pączek L. Costs of Post-Renal Transplant Care in the Final Period of Graft Function. Transplant Proc 2020;52(8):2368-2370
  • Turgutalp K, Ozturk S, Arici M, Eren N, Gorgulu N, Islam M, et al. Determinants of mortality in a large group of hemodialysis patients hospitalized for COVID-19. BMC Nephrol 2021;22(1):29
  • Goicoechea M, Sánchez Cámara LA, Macías N, Muñoz de Morales A, Rojas ÁG, Bascuñana A, et al. COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Kidney Int 2020;98(1):27-34
  • Yiqiong Ma, Bo Diao, Xifeng Lv, Wei Liang, Jili Zhu, Lei Liu, et al. 2019 novel coronavirus disease in hemodialysis (HD) patients: report from one HD center in Wuhan, China. medRxiv 2020
  • Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, et al. Hematological findings and complications of COVID-19. Am J Hematol 2020;95(7):834-847
  • Pujani M, Raychaudhuri S, Singh M, Kaur H, Agarwal S, Jain M, et al. An analysis of hematological, coagulation and biochemical markers in COVID-19 disease and their association with clinical severity and mortality: an Indian outlook. Am J Blood Res 2021;11(6):580-591. Published 2021 Dec 15.
  • Gubensek, J., Lolic, M., Ponikvar, R., & Buturovic-Ponikvar, J. D-dimer levels in maintenance hemodialysis patients: High prevalence of positive values also in the group without predisposing diseases. Hemodialysis international. International Symposium on Home Hemodialysis 2016; 20(2), 198–203
  • Diris JH, Hackeng CM, Kooman JP, Pinto YM, Hermens WT, van Dieijen-Visser MP. Impaired renal clearance explains elevated troponin T fragments in hemodialysis patients. Circulation 2004;109(1):23-5
  • Giannitsis E, Katus HA. Troponin T release in hemodialysis patients. Circulation 2004;110(3):e25-6; author reply e25-6
  • Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest 2020;130(5):2620-9
  • Boonnak K, Vogel L, Feldmann F, Feldmann H, Legge KL, Subbarao K. Lymphopenia associated with highly virulent H5N1 virus infection due to plasmacytoid dendritic cell-mediated apoptosis of T cells. J Immunol 2014;192(12):5906-12.
  • Cizmecioglu A, Akay Cizmecioglu H, Goktepe MH, Emsen A, Korkmaz C, Esenkaya Tasbent F, et al. Apoptosis-induced T-cell lymphopenia is related to COVID-19 severity. J Med Virol. 2021 May;93(5):2867-2874
  • Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis 2020; 71(15):762-768
  • Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395(10229):1054-1062
  • Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA 2020;323(20):2052-2059
  • Akalin E, Azzi Y, Bartash R, Seethamraju H, Parides M, Hemmige V, et al. Covid-19 and Kidney Transplantation. N Engl J Med 2020;382(25):2475-2477
  • Scarpioni R, Manini A, Valsania T, De Amicis S, Albertazzi V, Melfa L, et al. Covid-19 and its impact on nephropathic patients: the experience at Ospedale "Guglielmo da Saliceto" in Piacenza. G Ital Nefrol 2020;37(2):2020-vol2
  • Alberici F, Delbarba E, Manenti C, Econimo L, Valerio F, Pola A, et al. Management of Patients on Dialysis and With Kidney Transplantation During the SARS-CoV-2 (COVID-19) Pandemic in Brescia, Italy. Kidney Int Rep 2020;5(5):580-585

Böbrek Nakli ve Hemodiyaliz Hastalarında COVID-19 Rikoşeleri

Year 2023, , 309 - 315, 30.06.2023
https://doi.org/10.54005/geneltip.1251579

Abstract

Arka Plan/Amaçlar: Bozulmuş bir bağışıklık cevabı, Coronavirüs 2019 (COVID-19) hastalığının prognozunu etkiler. Hem hemodiyaliz (HD) hem de Böbrek Nakli (BN) hastalarının bağışıklıkları zaten baskılıdır. Bu çalışma COVID-19'lu HD ve BN hastalarında prognostik laboratuvar sonuçlarını değerlendirmiştir.
Yöntemler: Bu retrospektif, vaka kontrol çalışması, PCR (+) COVID-19 HD ve BN hastaları ve kontrol grubu ile gerçekleştirildi. Tüm hastalar hastalık şiddetine göre iki alt gruba ayrıldı. Hastaların demografik kayıtları ve laboratuvar sonuçları takip dosyalarından elde edildi.
Bulgular: Çalışmaya toplam 30 HD, 20 BN hastası ve 40 kontrol grubu dahil edildi. Cinsiyet ve hastanede yatış süresi gruplar arasında farklılık göstermedi. BN grubunda %10, HD grubunda %27 ölüm oranı vardı. Bilgisayarlı Tomografide (BT) akciğer tutulumu HD hastalarında (%47) BN'ye (%25) göre daha yüksekti. Alt grup değerlendirmelerinde hastalık şiddetinin belirlenmesinde HD hastalarında fibrinojen, BN hastalarında ise LDH ve Ferritin öne çıkan laboratuvar değerleriydi.
Sonuç: BT ve laboratuvar sonuçları COVID-19 pandemisinde bu tarz hasta gruplarında prediktif olmadığı için erken yatış ve tedavi uygulamaları HD ve BN hastalarında iyi bir prognoz ile ilişkili olacaktır.

References

  • Mahase E. Covid-19: WHO declares pandemic because of "alarming levels" of spread, severity, and inaction. BMJ 2020;368:m1036
  • WHO (2022) Coronavirus Disease (COVID-19) Dashboard. https://covid19.who.int/. Accessed 19 April 2022
  • Weiss P, Murdoch DR. Clinical course and mortality risk of severe COVID-19. Lancet 2020;395(10229):1014-1015
  • Pascarella G, Strumia A, Piliego C, Bruno F, Del Buono R, Costa F, et al. COVID-19 diagnosis and management: a comprehensive review. J Intern Med 2020;288(2):192-206
  • Alberici F, Delbarba E, Manenti C, Econimo L, Valerio F, Pola A, et al. A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia. Kidney Int 2020;97(6):1083-1088
  • W. Guan, Z. Ni, Yu Hu, W. Liang, C. Ou, J. He, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020;382(18):1708-1720
  • Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020;323(11):1061-1069
  • Jiang F, Deng L, Zhang L, Cai Y, Cheung CW, Xia Z. Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19). J Gen Intern Med 2020;35(5):1545-1549
  • Azzi Y, Bartash R, Scalea J, Loarte-Campos P, Akalin E. COVID-19 and Solid Organ Transplantation: A Review Article. Transplantation 2021;105(1):37-55
  • Vaziri ND, Pahl MV, Crum A, Norris K. Effect of uremia on structure and function of immune system. J Ren Nutr 2012;22(1):149-56
  • Lee IC, Huo TI, Huang YH. Gastrointestinal and liver manifestations in patients with COVID-19. J Chin Med Assoc. 2020;83(6):521-523
  • Mao R, Qiu Y, He JS, Tan JY, Li XH, Liang J, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2020;5(7):667-678
  • Dashti-Khavidaki S, Khalili H, Nourian A. Pharmacotherapy Considerations in CKD Patients With COVID-19, A Narrative Review. Iran J Kidney Dis 2020;14(4):247-255.
  • Coulter CV. The role of the suspicious renal pharmacist in identifying unusual adverse drug reactions-why this is not a small problem. Int J Clin Pharm 2018;40(4):775-777
  • https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum/
  • Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395(10223):507-13.
  • Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. J Intensive Care 2020;8:36.
  • Tang HM, Tang HL. Anastasis: recovery from the brink of cell death. R Soc Open Sci 2018;5(9):180442.
  • Łabuś A, Niemczyk M, Kulesza A, Fliszkiewicz M, Pączek L. Costs of Post-Renal Transplant Care in the Final Period of Graft Function. Transplant Proc 2020;52(8):2368-2370
  • Turgutalp K, Ozturk S, Arici M, Eren N, Gorgulu N, Islam M, et al. Determinants of mortality in a large group of hemodialysis patients hospitalized for COVID-19. BMC Nephrol 2021;22(1):29
  • Goicoechea M, Sánchez Cámara LA, Macías N, Muñoz de Morales A, Rojas ÁG, Bascuñana A, et al. COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Kidney Int 2020;98(1):27-34
  • Yiqiong Ma, Bo Diao, Xifeng Lv, Wei Liang, Jili Zhu, Lei Liu, et al. 2019 novel coronavirus disease in hemodialysis (HD) patients: report from one HD center in Wuhan, China. medRxiv 2020
  • Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, et al. Hematological findings and complications of COVID-19. Am J Hematol 2020;95(7):834-847
  • Pujani M, Raychaudhuri S, Singh M, Kaur H, Agarwal S, Jain M, et al. An analysis of hematological, coagulation and biochemical markers in COVID-19 disease and their association with clinical severity and mortality: an Indian outlook. Am J Blood Res 2021;11(6):580-591. Published 2021 Dec 15.
  • Gubensek, J., Lolic, M., Ponikvar, R., & Buturovic-Ponikvar, J. D-dimer levels in maintenance hemodialysis patients: High prevalence of positive values also in the group without predisposing diseases. Hemodialysis international. International Symposium on Home Hemodialysis 2016; 20(2), 198–203
  • Diris JH, Hackeng CM, Kooman JP, Pinto YM, Hermens WT, van Dieijen-Visser MP. Impaired renal clearance explains elevated troponin T fragments in hemodialysis patients. Circulation 2004;109(1):23-5
  • Giannitsis E, Katus HA. Troponin T release in hemodialysis patients. Circulation 2004;110(3):e25-6; author reply e25-6
  • Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest 2020;130(5):2620-9
  • Boonnak K, Vogel L, Feldmann F, Feldmann H, Legge KL, Subbarao K. Lymphopenia associated with highly virulent H5N1 virus infection due to plasmacytoid dendritic cell-mediated apoptosis of T cells. J Immunol 2014;192(12):5906-12.
  • Cizmecioglu A, Akay Cizmecioglu H, Goktepe MH, Emsen A, Korkmaz C, Esenkaya Tasbent F, et al. Apoptosis-induced T-cell lymphopenia is related to COVID-19 severity. J Med Virol. 2021 May;93(5):2867-2874
  • Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis 2020; 71(15):762-768
  • Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395(10229):1054-1062
  • Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA 2020;323(20):2052-2059
  • Akalin E, Azzi Y, Bartash R, Seethamraju H, Parides M, Hemmige V, et al. Covid-19 and Kidney Transplantation. N Engl J Med 2020;382(25):2475-2477
  • Scarpioni R, Manini A, Valsania T, De Amicis S, Albertazzi V, Melfa L, et al. Covid-19 and its impact on nephropathic patients: the experience at Ospedale "Guglielmo da Saliceto" in Piacenza. G Ital Nefrol 2020;37(2):2020-vol2
  • Alberici F, Delbarba E, Manenti C, Econimo L, Valerio F, Pola A, et al. Management of Patients on Dialysis and With Kidney Transplantation During the SARS-CoV-2 (COVID-19) Pandemic in Brescia, Italy. Kidney Int Rep 2020;5(5):580-585
There are 36 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Article
Authors

Mevlüt Hakan Göktepe 0000-0003-1711-5157

Hilal Akay Çizmecioglu 0000-0002-3312-4638

Ali Kürşat Tuna 0000-0002-7453-326X

Ahmet Cizmecioglu 0000-0002-8991-2676

Early Pub Date June 30, 2023
Publication Date June 30, 2023
Submission Date February 15, 2023
Published in Issue Year 2023

Cite

Vancouver Göktepe MH, Akay Çizmecioglu H, Tuna AK, Cizmecioglu A. COVID-19 Ricochets on Kidney Transplant and Hemodialysis Patients. Genel Tıp Derg. 2023;33(3):309-15.