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Transplant Proc
. 2021 Jan 13;S0041-1345(21)00003-8.
doi: 10.1016/j.transproceed.2021.01.002. Online ahead of print.
Coronavirus Disease 2019 in Kidney Transplant Recipients: Single-Center Experience and Case-Control Study
Anna Hardesty 1 , Aakriti Pandita 2 , Kendra Vieira 2 , Ralph Rogers 2 , Basma Merhi 3 , Adena J Osband 4 , Jad Aridi 2 , Yiyun Shi 5 , George Bayliss 3 , Christopher Cosgrove 3 , Reginald Gohh 3 , Paul Morrissey 4 , Curt G Beckwith 2 , Dimitrios Farmakiotis 6
Affiliations
- PMID: 33573820
- PMCID: PMC7836220
- DOI: 10.1016/j.transproceed.2021.01.002
Abstract
Background: Kidney transplant recipients (KTR) are considered high-risk for morbidity and mortality from coronavirus disease 2019 (COVID-19). However, some studies did not show worse outcomes compared to non-transplant patients and there is little data about immunosuppressant drug levels and secondary infections in KTR with COVID-19. Herein, we describe our single-center experience with COVID-19 in KTR.
Methods: We captured KTR diagnosed with COVID-19 between March 1, 2020 and May 18, 2020. After exclusion of KTR on hemodialysis and off immunosuppression, we compared the clinical course of COVID-19 between hospitalized KTR and non-transplant patients, matched by age and sex (controls).
Results: Eleven KTR were hospitalized and matched with 44 controls. One KTR and 4 controls died (case fatality rate: 9.1%). There were no significant differences in length of stay or clinical outcomes between KTR and controls. Tacrolimus or sirolimus levels were >10 ng/mL in 6 out of 9 KTR (67%). Bacterial infections were more frequent in KTR (36.3%), compared with controls (6.8%, P = .02).
Conclusions: In our small case series, unlike earlier reports from the pandemic epicenters, the clinical outcomes of KTR with COVID-19 were comparable to those of non-transplant patients. Calcineurin or mammalian target of rapamycin inhibitor (mTOR) levels were high. Bacterial infections were more common in KTR, compared with controls.