Migratory pattern of the coronavirus disease 2019 and high fatality rates among kidney transplant recipients: report from the Brazilian Multicenter Cohort Study

• Published in: Brazilian Journal of Nephrology Vol. 44; no. 3; pp. 428 - 433
• Main Authors: Cristelli, Marina Pontello, Sandes-Freitas, Tainá Veras de, Viana, Laila Almeida, Requião-Moura, Lúcio R, Andrade, Luis Gustavo Modelli de, Tedesco-Silva, Helio, Medina-Pestana, José
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Nefrologia 01-07-2022
• Subjects: Brazil - epidemiology; Brief Communication; Coronavirus; COVID-19; Humans; Kidney Transplant; Kidney Transplantation; Middle Aged; Mortality; Retrospective Studies; SARS-CoV-2; Brazil
• ISSN: 0101-2800; 2175-8239
• DOI: 10.1590/2175-8239-JBN-2021-0063

The unprecedented coronavirus disease 2019 (COVID-19) pandemic has affected kidney transplant (KT) recipients, with worldwide fatality rates around 25%. Considering the well-known Brazilian socio-demographic disparities, this report describes for the first time the main outcomes of COVID-19 in KT recipients according to Brazilian geographic regions.
This multicenter national retrospective analysis included data from KT recipients with confirmed COVID-19 between March and November 2020.
Thirty-five of the 81 centers (57% of KT activity in Brazil) reported 1,680 patients with COVID-19. The Northeast was the first to reach the peak in the number of infections. The Southeast, due to its population density, contributed with the largest number of patients. Patients had a median age of 52 years, 76% had hypertension and 34% diabetes, 75% were recipients of a deceased donor, and the time interval between diagnosis and transplantation was 5.9 years. In 53% of patients, immunosuppression was adjusted, and clinical support varied according to geographic region. Hospitalization was required for 65% of the patients, 35% of them needed intensive care, 25% mechanical ventilation, and 23% renal replacement therapy. The 90-day overall fatality was 21%, being 23% in the Southeast, 16% in the Northeast, and 19% in the Central-west and South regions.
The migratory pattern of the pandemic among KT recipients followed that of the general population and the outcomes were influenced by regional features. COVID-19 in KT recipients was associated with high utilization of health-care resources and higher fatality rates than those reported in the general population.