Impact of COVID-19 in transplantation and nephrology in India: A nationwide report from India.

Meshram, Dr. Hari Shankar; Kute, Dr. Vivek B.; Swarnalatha, Dr. G.; Hegde, Dr. Umapati; Sharma, Dr. Ashish; Sahay, Dr. Manisha; Guleria, Dr. Sandeep; Raju, Dr. Sree Bhushan; Eapen, Dr. Jeetu; Ray, Dr. Deepak S.; Chaudhary, Dr. Arpita Roy; Patel, Dr. Himanshu; S, Dr. Vishwanath; Pathak, Dr. Vivek; Agarwal, Dr. Dhananjay; Bahadur, Dr. M.M.; Verma, Dr. P.P.; Anandh, Dr. Urmila; Krishna, Dr. Amresh; Abraham, Dr. Abi; Mishra, Dr. Vineet

Background The impact of COVID-19 in a developing nation is sparsely reported and more importantly the discrepancies in public and private sectors are underexplored. Methods We retrospectively investigated the data on the impact of COVID-19 on renal transplantation, between 2019-2020 in a nationwide analysis from 8 public and 10 private sector hospitals of India. Results On comparing the yearly data, the number of living-related transplants and deceased donor transplants declined by 48% (2610 vs 1370) and 49% (194 vs 99) respectively. The out-patient numbers and in-center admissions decreased by 40.4 % (6,16,741 vs 3,67,962) and 30.8 % (73,190 vs 49,918) respectively. There was no increase in the number of renal or graft biopsies in the COVID-19 era. The number of waitlisted patients on hemodialysis was higher in public (3,04,898 vs 3,38,343) when compared to private (1,63,096 vs 1,50,292) in the last 2 years. Similarly, the number of waitlisted patients on peritoneal dialysis (4655 vs 3526) was higher in public sector compared to private sector (932 vs 745). The decline in living transplants during the pandemic was higher in public setups (58%) compared to the private (49%). On the contrary, the decline in deceased donation was higher in private (57.9%) relative to public (50.6%). Conclusion COVID-19 has adversely affected the transplantation activities across the Indian transplantation centers, with a disproportionately higher impact on waitlisted patients in public sector programs. A sound prioritization of healthcare resources is mandated to safeguard the most deprived and high-risk waitlisted patients during the pandemic.