249.3: Follow-up Status After Recovery From COVID-19 Infection in Kidney Transplant Recipients: A Single Center Experience From India Across Various Pandemic Waves

Introduction: There are dearth of knowledge for the follow-up studies with regards to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in kidney transplant recipients (KTR). We have previously reported first such report of a small cohort. Herein we analyse long term outcome of COVID-19 infection in KTR across different pandemic waves including delta and omicron wave. Methods: We conducted this retrospective, single center cohort study of hospitalized (n = 367) and non-hospitalized KTR (n = 197) for a median (range) follow-up of 14 (1-20) months who recovered from SARS-CoV-2 during May 2020 to Jan 2022. All confirmed RT-PCR cases with at least 3-month follow-up were included. The outcomes measured were persistent symptoms post-discharge; EuroQoL visual analogue score (EQ-VAS); EuroQoL 5-dimension score (E5-QD-5L) score and modified medical research dyspnea score (mMRC) at discharge, 3 months and last follow-up. Other outcomes were graft outcome and postulated COVID-19 sequelae. Results: The median(range) age of the cohort was 44 (15-71) years and COVID-19 severity ranged from asymptomatic (14%), mild (40%), moderate (36%) to severe (10%). The most common persistent symptom was generalized which significantly decreased in the follow-up (n = 110 vs. 53 vs. 11]; p-value = 0.0001) at discharge, 3-month, and last follow-up respectively. Decrement in the mean (standard deviation) EQ-VAS score from baseline was also improved (36 [13] vs. 17 [12.5] vs. 8 [12.0]; p-value < 0.0001). There was statistically significant improvement in all EQ-5D-5L scores in follow-up. There was no deterioration in mMRC scores during the follow-up Moderate- severe cases had significantly poorer overall scores initially, but there was no difference at long term follow-up. 27 of 30 graft losses reported had baseline chronic graft dysfunction at baseline. There were no unexplained deaths, pulmonary fibrosis, cardiovascular event or cerebrovascular event. Conclusion: We report the largest cohort of Indian transplant recipients with COVID-19 at longest follow-up. Improvement in quality of life and no postulated COVID-19 sequelae ensures that no residual abnormality exist in post-COVID-19 KTR.