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Abstract: PO0764

Clinical Outcomes of Hospitalized Kidney Transplant Recipients with COVID-19 in a Predominantly Minority Population

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Al Azzi, Yorg, Montefiore Medical Center, Bronx, New York, United States
  • Ajaimy, Maria, Montefiore Medical Center, Bronx, New York, United States
  • Liriano-Ward, Luz E., Montefiore Medical Center, Bronx, New York, United States
  • Pynadath, Cindy T., Montefiore Medical Center, Bronx, New York, United States
  • Loarte Campos, Pablo, Montefiore Medical Center, Bronx, New York, United States
  • Nandigam, Purna Bindu, Montefiore Medical Center, Bronx, New York, United States
  • Akalin, Enver, Montefiore Medical Center, Bronx, New York, United States
  • Alani, Omar, Montefiore Medical Center, Bronx, New York, United States
  • Parides, Michael K., Montefiore Medical Center, Bronx, New York, United States
Background

COVID-19 has been associated with increased morbidity in kidney transplant recipients. We aimed to identify risk factors for mortality in hospitalized kidney transplant recipients with COVID-19

Methods

We retrospectively reviewed the medical records of 75 kidney transplant recipients admitted for COVID-19 at our institution.

Results

Among the 75 patients, 28 (37%) died at a median 8 days (range, 1-36) after admission to the hospital. The Table summarizes the demographics and initial labs values of both groups. Most of our patients were Hispanic (54%) and African American (32%) and 97% had hypertension and 65% had diabetes mellitus. There was no difference between the two groups in terms of sex, type of transplant, time from transplant, immunosuppressive medications, medical comorbidities, presenting symptoms, temperature, or pulse oximetry values on admission. Non-survivors were older and had higher BMI. On admission most patients were lymphopenic, had low CD3/CD4/CD8 counts and had higher inflammatory markers (ferritin, d-dimer, CRP, procalcitonin, interleukine-6 levels). Non-survivors had statistically significant higher procalcitonin, IL-6 and pro-BNP levels on admission. More non-survivors required ICU stay (64% vs. 13%, p < 0.001), intubation (57% vs. 11%, p < 0,001) and renal replacement therapy (32% vs. 17%, p=0.17) compared to survivors. There was no difference in secondary bacterial infections, CMV viremia, DVT or stroke between the two groups. In a multivariate analysis, BMI (OR 1.15, CI 1.04-1.30, p= 0.017 per unit increase), higher procalcitonin (OR 4.16, 1.09-18.87, p=0.046) and proBNP levels (OR 1.017, 1.002-1.034, p=0.039, per 100 unit increase) on admission were associated with increased mortality.

Conclusion

COVID-19 is associated with increased mortality (37%) in our kidney transplant recipients and higher BMI, procalcitonin and proBNP levels at admission are associated with mortality.