COVID-19 in transplant recipients: Multicentric report of Mexican experience

Mónica Sánchez-Cárdenas, Servicio de Nefrología del Trasplante, Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
Enzo Vásquez-Jiménez, Departamento de Nefrología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Méx.; Departamento de Nefrología, Hospital Juárez de México; Ciudad de México, México
Ricardo I. Velázquez-Silva, Servicio de Nefrología del Trasplante, Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
Mario Vilatobá-Chapa, Departamento de Trasplante, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
Benjamín Gómez-Navarro, Departamento de Nefrología, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jal., México
Lucio O. Sánchez-Macías, Departamento, Hospital San Javier, Guadalajara, Jal., México
José M. Rodríguez-Chagolla, Departamento de Nefrología, Hospital Juárez de México; Ciudad de México, México
Ignacio García-Juárez, Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
Severo M. Abraham-Mancilla, Departamento de Trasplante, Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social, León, Gto., México
Luis E. Morales-Buenrostro, Servicio de Nefrología del Trasplante, Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
Idalia Parra-Ávila, Departamento de Trasplante, Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social, Mérida, Yuc. México
César Flores-Gama, Departamento de Nefrología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México

Background: Solid Organ Transplant recipients (SOTR) appear to be at particular high risk for critical COVID-19 due to immunosuppressive drugs and comorbidities. We report the first description of clinical course and short-term outcomes of kidney and liver transplant recipients with confirmed COVID-19 in Mexico. The objective of this paper was evaluate the clinical course of transplant patients with COVID-19 infection. Material and methods: We retrospectively evaluated SOTR (kidney and liver) over 18 years of age with confirmed diagnosis of COVID-19 from tertiary care centers in Mexico. Results: Data from 45 kidney transplant recipients were recorded. Median (IQR) age was 43 (IQR 25-70) years. Admission to hospital was required in 37 (75.5 %) patients, of which 8 (16.3%) were hospitalized at Intensive Care Unit (ICU). Acute kidney injury (AKI) stage was documented in 33 (67%) patients. The time of hospitalization was 8 (IQR 6-12) days. Six patients died (12.2%). Additionally, data from 10 liver transplant recipients were included. During their evolution, 5 / 10 required hospital admission and there were no deaths in this group. Conclusions: Transplant recipients show a higher fatality rate and complications from SARS-CoV-2 infection; more studies are needed to identify prognostic factors and effective anti-SARS-CoV-2 therapies.

Keywords: COVID-19. Transplant. Kidney. Liver. Mortality. Immunosuppression.