Abstract: TH-PO947
COVID-19 Outcomes in Kidney Transplant During in the Period of Omicron Predominance
Session Information
- COVID-19: Vaccines and Outcomes ESRD/KTR
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Bernardo, João Filipe, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Gonçalves, Sara, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Rodrigues, Natacha, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Santos, Noélia Lopez, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Goncalves, Joao Albuquerque, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Abreu, Fernando, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Neves, Marta R.A., Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Santana, Alice, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Lopes, Jose António, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
- Godinho, Iolanda, Centro Hospitalar Universitario Lisboa Norte EPE, Lisboa, Lisboa, Portugal
Background
In 2022' first trimester the Omicron SARS-COV-2 variant (OV) was the most prevalent in Portugal. OV is associated to greater transmissibility and less severe disease in immunocompetent patients but less is known about the clinical characteristics of the OV in immunosuppressed patients, namely in kidney transplant recipients (KTR). The authors aim to characterize and compare the clinical characteristics of KTR infected during SARSCOV2 Omicron and Delta wave.
Methods
Single center retrospective cohort study of KTR (n=675) to analyze the clinical outcomes of SARS-COV-2 infection throughout the epidemic waves: June-November 2021 - Delta predominant wave (DPW); January-March 2022 - Omicron predominant Wave (OPW). Data were collected from electronic clinical records. Continuous variables were compared using t student tests and categorical variables with Chi-square tests.
Results
SARSCOV2 infection incidence in the KTR was significantly higher during the OPW than during the DPW (DPW 10.7% vs OPW 3.7%, p<0.001). Most patients had booster of SARSCOV2 vaccine at the time of the diagnosis of SARS-COV-2 infection (DPW 88.8% vs OPW 91.6%, pns). Patients infected during OPW had lower hospitalization rates (OPW 20.8% vs DPW 44.0%, p0,024), less need for invasive ventilation (OPW 4,1% vs DPW 24% p0.003), lower rates of admission to Intensive Care Unit (ICU) (OPW 4.1% vs DPW 24% p0.003) and lower mortality rates (OPW 5,6% vs DPW 24,0%, p0,009). In hospitalized patients, respiratory failure rates were similar between both waves (OPW 81.9% vs DPW 81.8%, pns) and there was similar percentage of lung parenchyma involvement as determined by computed tomography scan (parenchymal involvement> 50%: OPW 53.4% vs DPW 63.5%, pNS). Although not statistically different, there was a higher prevalence of acute kidney graft injury at hospital admission during the OPW (OPW 53.3% vs DPW 18.2%, pns).
Conclusion
OV was associated to higher infection rates but less severe respiratory disease, lower admission to the ICU and lower mortality rates than Delta SARSCOV2 in KTR. Nonetheless severe pulmonary involvement occurred in a few cases and mortality seems to be higher than in the general population. Thus, preventive strategies of OV infection in KTR should go beyond vaccination.