Monitoring and telematic control of people with kidney transplant and suspected COVID-19 infection

Abstract

Background: People with Kidney Transplantation require immunosuppressant treatments and this classifies them as a population at risk for virus and/or bacterial infections. The objective of the study was to describe the follow-up of transplanted people with suspected COVID19 infection.

Methods: Descriptive, cross-sectional, observational study with prospective follow-up carried out between March and June 2020. Sociodemographic and clinical data were recorded for the assessment, control and follow-up of the cases. The results were expressed with means and standard deviation, median and interquartile range, or frequencies and percentages. The chi-square test was used to compare qualitative variables and the Student’s T test to compare quantitative variables with normal distribution. If they did not follow a normal distribution, the Mann Whitney U test was used. The level of statistical significance was established at p<0.05.

Results: A total of 56 patients were included, with a mean of 62.73±13.01 years and a median of 39.5 [7.5; 93] months transplanted. 2.48±2.69 calls/patient were made during a period of 3.46±4.41 days. Virtual follow-up was performed with 100% (n=56) and 71.43% (n=40) required hospital admission at some point. 28.57% (n=16) of the people evaluated were managed at home. The PCR test was performed on 85.71% (n=48) of the study population, being positive in 48.21% (n=27). 29.62% (n=8) of the positive cases required invasive mechanical ventilation and 33.33% (n=9) died. The mortality rate in the study population is 4.17 times higher than that presented in the data from the registries in the general population.

Conclusions: According to the mortality data, it is essential to maintain close contact with the main objective of referring the case to the hospital system at the slightest suspicion of complication. Remote monitoring is offered as a positive opportunity for the control of transplant recipients who require close monitoring by the nursing team.