COVID-19 mortality high in kidney transplant recipients, say experts

CHENNAI: COVID-19 mortality in kidney transplant recipients (KTR) is much higher compared to the general population, a recent study in India has concluded. However, local doctors state that the number is relatively low in Chennai and comorbidities and timely intervention remain the key factor in preventing deaths.

According to the study, which is to be published in the magazine ‘Transplantation’, the mortality rate in KTR patients inflicted with COVID-19 was higher than the general public. The cohort study was conducted across 13 transplant centres in India between March and September 2020. Local doctors, meanwhile, point out that access to healthcare during this period was low, and could have contributed to the deaths.

“During the initial months, we saw lesser patients due to the lockdown. Also, there was less access to hospitals, and patients themselves were hesitant to visit hospitals. This led to a delayed intervention, which could have led to complications, ” said Dr R Balasubramaniyam, Chief Nephrologist, Kauvery Hospital.

Regulation of medication continues to be an important factor in avoiding mortality, and timing and follow-up adherence are also important in COVID-19 treatment. “For COVID-19 KTR patients, we followed the immunosuppression steroid protocol and steroid administration protocol. Most of these patients develop a secondary infection with prolonged ventilator use and hospital stay, so the time of hospitalisation also affects their mortality. Timely intervention by medical professionals after symptoms surface is also key in preventing mortality,” said Dr Muthu Kumar P, Senior Consultant Nephrologist and Transplant Physician, Gleneagles Global Health City.

However, a key factor in mortality for KTR patients are the comorbid conditions, said Dr V Chandrasekaran, Senior Consultant and the Clinical Lead of the Department of Nephrology and Kidney Transplant, MGM Healthcare. “While we can adjust the immunosuppression regime and medication accordingly, co-morbid conditions like diabetes, which is prevalent in about 30 per cent of KTR patients, play an important role in the outcome. Other factors like age, weight and sex of the patient must also be taken under consideration,” he said.

However, doctors state that the KTR mortality rate of COVID-19 is likely to reduce, following clearer treatment protocol owing to more cases appearing in the city. Additionally, Dr Chandrasekaran states that given the spread of COVID-19, patients who do not need urgent and critical transplants can follow alternate treatments until conditions become stable once more.