Long-term follow-up of SARS-CoV-2 recovered renal transplant recipients: A single-center experience from India

Abstract

Introduction: Follow-up studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in kidney transplant recipients (KTR) are scarcely reported. Methods: We studied 142 hospitalized KTR for a median (interquartile range) follow-up of 9 (8–11) months who recovered from SARS-CoV-2 during May 2020 to Dec 2020. The outcomes were to assess persistent symptoms post-discharge; EuroQoL visual analogue score (EQ-VAS); EuroQoL 5-dimension score (E5-QD-5L) score and modified medical research dyspnea score (mMRC) at 1 month, 3-month, and beyond 6 months. Graft outcome was also analyzed. Results: The age of the cohort was 43 (34–69) years and COVID-19 severity ranged from asymptomatic (4%), mild (50%), moderate (35%) to severe (12%). The most common persistent symptom was fatigue which significantly decreased in the follow-up (n = 45 [32.3] vs. 10 [7.4] vs. 4 [2.9]; p-value = 0.001) at 1-month, 3-month, and beyond 6 months respectively. Decrement in the mean (standard deviation) EQ-VAS score from baseline was also improved (28.6 [13] vs. 10.4 [12.5] vs. 7.5 [12.0]; p-value = 0.012). There was significant improvement in all EQ-5D-5L scores in follow-up. There was no deterioration in mMRC scores during the follow-up (n = 4, 3% vs. 7, 5% vs. 3, 2%; p-value = 0.86). Cases requiring oxygen had significantly poorer overall scores initially, but there was no difference at 6 months. All 10 graft losses had oxygen requirement and chronic graft dysfunction at baseline. Conclusion: Our initial assessment reports significant improvement in the quality of life in follow-up. The majority recovered from allograft dysfunction. Further research is warranted to study the full spectrum of follow-up.