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Kidney Week

Abstract: PO0776

COVID-19 in Kidney Transplant Recipients at New England's Largest Safety-Net Hospital

Session Information

Category: Coronavirus (COVID-19)

  • No subcategory defined

Authors

  • Mahmoud, Hassan, Boston University, Boston, Massachusetts, United States
  • Ghai, Sandeep, Boston University, Boston, Massachusetts, United States
  • Francis, Jean M., Boston University, Boston, Massachusetts, United States
Background

The coronavirus disease 2019 (COVID-19) has led to a global pandemic as announced by the World Health Organization. Kidney transplant patients are thought to constitute a unique high risk group for severe COVID19 infection. Furthermore, disparities in health care have led to COVID-19 disproportionately affecting minority groups including African Americans and Hispanics.

Methods

We identified adult kidney transplant recipients who were admitted with COVID-19 between March, 15th and May 1st, 2020. We evaluated the demographic, clinical and laboratory data of all admitted patients. We also evaluated the presence of co-infections as well as decisions regarding immunosuppressant management.

Results

23 kidney transplant recipients who were hospitalized for COVID-19 were evaluated. 91% of our patients were of minority groups. 35% of patients required ICU admission, and 30% required mechanical ventilation. 40% of patients had associated coinfections in addition to COVID19. 87% of patients had variable degrees of AKI, 26% of patients with AKI required renal replacement therapy. Mortality rate in our population was 22%.
Upon admission to the hospital, our immunosuppressant therapeutic approach included stopping the antimetabolites and continuing with the calcineurin inhibitors (targeting trough level of 4 to 6 ng/dl for tacrolimus and 50 ng/dl for cyclosporine), and prednisone if patients were on steroids.

Conclusion

This report demonstrates higher rate of AKI, coinfection and mortality in kidney transplant patients in the setting of COVID19 as compared to general population.