ABSTRACT
Background: The aim of our analysis was to evaluate the impact
of the COVID-19 pandemic on the procurement program and kidney
transplantation in Slovakia and to identify the risk factors for a
severe course of COVID-19 disease, as well as the risk factors for
COVID-19 fatalities, with focus on the parameters preceding the
infection.
Methods: 305 KTRs (68.8% males) with confirmed SARS-CoV-2
positivity were included in the multicentric retrospective analysis.
Results: The procurement program and kidney transplants in
Slovakia dropped in the observed period by 28.6% (P<0.0001)
and by 33.5% (P<0.0001) respectively. Age over 59 years
(OR=1.03, P=0.0088) and diabetes mellitus (OR=2.04, P=0.0106) were
identified as independent risk factors for severe course of the disease.
Risk factors for death were age over 59 years (OR=1.05, P=0.0003) and
graft dysfunction with CKD-EPI<0.5 mL/s (OR=4.87, P=0.0029).
The prevalence of the alpha variant in Slovakia was associated with a
severe course in KTRs treated with corticoids (OR=5.72, P=0.0273) and in
graft dysfunction with CKD-EPI<0.5 mL/s (OR=2.94, P=0.0076);
the risk of death was higher in KTRs over 59 years (OR=1.07, P=0.0173)
and again with CKD-EPI<0.5 mL/s (OR=4.42, P=0.0393). KTRs had
a 3.7 times lower risk of infection compared to hemodialysis patients
(14% vs 52%, P<0.0001), with mortality of 9.8%vs 30% (P<0.0001).
Conclusion: The procurement and transplant program is
sustainable even during a pandemic, provided that measures are set up
quickly. Morbidity and mortality from COVID-19 in KTRs was comparable to
the situation in EU countries.