Outcome of mild SARS-CoV-2-infected renal transplant recipients managed by supervised home-based self-monitoring - 30/07/22
Highlights |
• | Experience on ambulatory management of COVID-19 in renal transplant recipients (RTR) is limited. |
• | As in-hospital resources were limited during the pandemic, even this high-risk group with mild COVID-19 needed to be managed on an outpatient basis. |
• | The supervised home-based self-monitoring (HBSM) strategy resulted in similar outcomes to that of the inpatient management of RTRs with mild COVID-19. |
• | HBSM is a good alternative in the face of limited inpatient services. |
Abstract |
Objectives |
We aimed to compare the outcomes of COVID-19 Renal Transplant Recipients (RTRs) managed on an ambulatory basis to that of inpatient management.
Design, setting, materials, and methods |
We performed a retrospective study in Lucknow, India, comparing the ambulatory management with the historical cohort managed in the hospital.R RTRs with mild COVID-19 were managed by supervised home-based self-monitoring (HBSM), a strategy to manage this high-risk group on an outpatient basis during the second wave of the pandemic. The primary outcome was the clinical deterioration to a higher severity category among RTRs with mild COVID-19 managed by HBSM compared to hospitalized patients within two weeks of disease onset.
Results |
Of the 149 RTRs with mild COVID-19, 94 (63%) and 55 (37%) were managed by HBSM and in the hospital, respectively. The proportion of RTRs who clinically deteriorated to a higher severity category (moderate or severe category) was similar among both groups (28.7% versus 27.2%, P=0.849). Among RTRs with clinical deterioration, COVID-19-related death was reported in two patients of the HBSM group and in none of the patients of the hospitalized group. Graft dysfunction was higher in the hospitalized group (7.4% versus 27.2%, P=0.002). Median time to complete clinical recovery (7 days in both groups), secondary bacterial infections (25% versus 33.3%, P=0.41), and the mean decline in EQ-5D score from baseline at six weeks (–6.6 versus–4.3, P=0.105) were found to be similar in both groups.
Le texte complet de cet article est disponible en PDF.Keywords : SARS-CoV-2, COVID-19, Ambulatory treatment, Renal transplant
Plan
Vol 52 - N° 5
P. 286-293 - août 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.