Morbidity of COVID-19 in Kidney Transplant Patients

Kidney transplant patients are vulnerable to severe COVID-19 infection due to chronic immunosuppression and underlying chronic conditions. Many of these chronic conditions cause kidney failure which leads to kidney transplantation.  

A multicenter study conducted between March 2 - May 15, 2020, shows that kidney transplant recipients hospitalized with COVID-19 infection are at high risk for acute kidney injury and death. 

A 9-week study was conducted at 12 transplant centers in the US, Italy, and Spain. 

• 144 kidney transplant patients were hospitalized for COVID-19 infection. 

• Notable outcomes were acute kidney injury in half, respiratory failure in 29%, and death in 32% during a median follow-up of 52 days.
• Death was more likely with advanced age, and not with a particular anti-rejection medication.
• Those who died also had lower lymphocyte counts and estimated renal function, and higher serum lactate dehydrogenase, procalcitonin, and interleukin-6 levels. 
• These patients had a high incidence of underlying conditions: high blood pressure in 95%, diabetes or obesity in half, heart disease in a fourth, and lung disease in a fifth.

The results of this study are pertinent to an earlier phase of the COVID-19 pandemic. Follow-up reports can help define whether antiviral drugs, convalescent plasma, and dexamethasone have improved outcomes of COVID-19 in this vulnerable population. 

Link: https://onlinelibrary.wiley.com/doi/10.1111/ajt.16185