Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Aug 18, 2022; 12(8): 250-258
Published online Aug 18, 2022. doi: 10.5500/wjt.v12.i8.250
Emergency department visits and hospital admissions in kidney transplant recipients during the COVID-19 pandemic: A hospital-based study
Wachira Wongtanasarasin, Phichayut Phinyo
Wachira Wongtanasarasin, Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Wachira Wongtanasarasin, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA 95817, United States
Phichayut Phinyo, Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Phichayut Phinyo, Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Author contributions: Wongtanasarasin W and Phinyo P designed the protocol, contributed to data collection, and data analyses; Wongtanasarasin W contributed to the formal analysis and wrote the first draft of the manuscript; and all authors read and critically reviewed the final version of the manuscript.
Institutional review board statement: The study protocol was approved by the Institutional Review Board of the Faculty of Medicine, Chiang Mai University (EXEMPTION-8745/65).
Informed consent statement: The Institutional Review Board of the Faculty of Medicine, Chiang Mai University waived informed consent due to its retrospective design.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE-Checklist, and the manuscript was prepared and revised according to the STROBE-Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wachira Wongtanasarasin, MD, Attending Doctor, Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, 110 Intavarorot Street, Sriphum, Chiang Mai 50200, Thailand. wachir_w@hotmail.com
Received: January 28, 2022
Peer-review started: January 28, 2022
First decision: March 25, 2022
Revised: March 27, 2022
Accepted: July 25, 2022
Article in press: July 25, 2022
Published online: August 18, 2022
Abstract
BACKGROUND

Several studies have demonstrated that the coronavirus disease 2019 (COVID-19) has affected daily living and the healthcare system. No previous study has described the consequences of COVID-19 on emergency department (ED) visits and hospital admission among kidney transplant (KT) recipients.

AIM

To investigate the impact of the COVID-19 pandemic on ED visits and hospital admissions within 1 year in patients who underwent KT in Thailand.

METHODS

We conducted a retrospective study at a university hospital in Thailand. We reviewed the hospital records of KT patients who visited the ED during the outbreak of COVID-19 (from January 2020 to December 2021). We used the previous 2 years as the control period in the analysis. We obtained baseline demographics and ED visit characteristics for each KT patient. The outcomes of interest were ED visits and ED visits leading to hospital admission within the 1st year following a KT. The rate of ED visits and ED visits leading to hospital admissions between the two periods were compared using the stratified Cox proportional hazards model.

RESULTS

A total of 263 patients were included in this study: 112 during the COVID-19 period and 151 during the control period. There were 34 and 41 ED visits after KT in the COVID-19 and control periods, respectively. The rate of first ED visit at 1 year was not significantly different in the COVID-19 period, compared with the control period [hazard ratio (HR) = 1.02, 95% confidence interval (CI): 0.54-1.92; P = 0.96]. The hospital admission rate was similar between periods (HR = 0.92, 95%CI: 0.50-1.69; P = 0.78).

CONCLUSION

ED visits and hospital admissions within the 1st year in KT recipients were not affected by the COVID-19 pandemic. Despite these findings, we believe that communication between post-KT patients and healthcare providers is essential to highlight the importance of prompt ED visits for acute health conditions, particularly in post-KT patients.

Keywords: Emergency department visit, Hospital admission, Kidney transplant, COVID-19, Acute health conditions

Core Tip: Coronavirus disease 2019 (COVID-19) affects kidney transplant (KT) recipients in terms of hospital admission rates. This study showed that despite emergency department (ED) visits remaining unchanged during the COVID-19 pandemic, hospital admission rates increased. Although we could not establish the cause-effect relationship of these changes, we encourage healthcare providers to provide post-KT patients recommendations to visit ED promptly for acute health conditions.