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Abstract: PO0851

Glomerular Diseases and Immunosuppression Practices in Latin America During the COVID-19 Pandemic: Analysis from GlomCon Latin America Working Group (LGlomCon)

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Gutierrez-Prieto, Julio Alejandro, Hospital Central del Estado de Chihuahua, Chihuahua, Chihuahua, Mexico
  • Cabeza Rivera, Franco H., University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Rodriguez Ramirez, Sonia, Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada
  • Soto-Vargas, Javier, Hospital General Regional 46, IMSS., Guadalajara, Jalisco, Mexico
  • Arellano-Mendez, Denisse, Unidad Medica de Atencion Ambulatoria 254, IMSS, Morelia, Michoacan, Mexico
  • Garcia Anton, Desiree, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Aguirre, Diana, Hospital General de Mexicali, Mexicali, Baja California, Mexico
  • Martinez-Chagolla, Blanca, Hospital General de Morelia "Dr. Miguel Silva", Morelia, Michoacan, Mexico
  • Avila-Casado, Carmen, Pathology Department, University Health Network, Toronto, Ontario, Canada

Group or Team Name

  • GlomCon Latin America Working Group
Background

As COVID-19 spreads across the world, nephrologists are facing difficult decisions regarding the management of active glomerular diseases (GD). We aimed to report how COVID-19 pandemic may have changed the use of immunotherapies among nephrologists In Latin America (LA) for the treatment of glomerulopathies.

Methods

Descriptive analysis extracted from an online survey carried out among nephrologists, renal pathologists and other health workers treating kidney diseases between May 20-27, 2020 from sixteen Spanish speaking LA countries divided into 6 categories. We present the results for the GD and immunosuppression category.

Results

430 responses were obtained of which 360 (84%) were considered for analysis.The participants were mainly nephrologists 276 (86%), renal pathologists 13 (4%) and physicians in training 11 (3%). 213 (59%) of the respondents treat patients with GD. For patients at risk but without COVID-19 infection, the induction immunosuppression for GD treatment was not changed by 54.1% of the respondents while 24.2% gave only a fraction of it and 21.7% deferred the induction treatment. For maintenance immunosuppression, the same regimen was maintained by 74.2% of the respondents, 24.3% decreased it and 1.5% suspended it completely. In case of relapse or flare, 53.6% used standard increase of immunosuppression, 39.7% increased it but at lower levels than usual and 6.7% continued the maintenance regimen. For patients already on immunosuppression diagnosed with COVID-19 infection, 42% would decrease immunosuppressive regimens for mild disease, 62.3% in case of moderate disease and 70.8% would consider completely discontinuing immunosuppression in case of severe disease.

Conclusion

Over 40% of the respondents in LA are already prescribing lower than recommended doses of immunosuppression for induction, relapses or flares as a preventive strategy in the context of COVID-19 pandemic. How this change in practice would affect the renal outcomes remains to be seen. The experience in the treatment of GD in patients with concurrent COVID-19 infection remains limited.