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).