MATERIALS AND METHODS
In a retrospective multicentric analysis, we included SARS-CoV-2 positively tested patients after kidney transplantation monitored in all four transplant centers in Slovakia – the University Hospital in Bratislava, Banská Bystrica, Martin, and Košice. The data were collected for the period from March 6, 2020 to March 31, 2021. Positivity was confirmed by real-time polymerase chain reaction (RT-PCR) test. We recorded age, time (months) after transplantation, diabetes mellitus and arterial hypertension history, BMI (body mass index) and graft function at the time of the test positivity, and telephone consultation with the transplant center by the patient or the treating physician from the hospital where the infected patient was admitted in relation to COVID-19 and its treatment. We evaluated the type and doses/levels of immunosuppression and treatment with angiotensin-converting enzyme inhibitors (ACE-I) at the time of the test positivity.
The group of patients was divided into three subgroups according to the COVID-19 pandemic period:
Subgroup 1: the first wave of COVID-19 crisis (March 6, 2020 – August 31, 2020).
Subgroup 2: the first period of the second wave (September 1, 2020 – December 31, 2020).
Subgroup 3: the second period of the second wave – prevalence of the alpha variant of SARS-CoV-2 as confirmed by sample sequencing (January 1, 2021 – March 31, 2021).
Further division based on the clinical course of the disease was into asymptomatic or moderate course – patients were treated at home; and severe course requiring hospitalization.
For the purposes of the analysis, the doses were unified and mycophenolic acid (MPA) was recalculated to mycophenolate mofetil (MMF). Similar approach was used in recalculation of methylprednisolone to prednisolone.
To compare the mortality rate to that of the hemodialysis patients, we employed information from 34 dialysis clinics reporting data to Nephrocare European Clinical Database (EuClid5).