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Kidney Week

Abstract: PO0772

ESKD Patients with COVID-19 vs. Kidney Transplant Recipients with COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Salinas, Thalia, NYP-Weill Cornell, New York, New York, United States
  • Lubetzky, Michelle L., NYP-Weill Cornell, New York, New York, United States
  • Craig-Schapiro, Rebecca, NYP-Weill Cornell, New York, New York, United States
  • Aull, Meredith J., NYP-Weill Cornell, New York, New York, United States
  • Lee, John Richard, NYP-Weill Cornell, New York, New York, United States
  • Lee, Jun B., NYP-Weill Cornell, New York, New York, United States
  • Sultan, Samuel, NYP-Weill Cornell, New York, New York, United States
  • Hartono, Choli, NYP-Weill Cornell, New York, New York, United States
  • Muthukumar, Thangamani, NYP-Weill Cornell, New York, New York, United States
  • Kapur, Sandip, NYP-Weill Cornell, New York, New York, United States
  • Suthanthiran, Manikkam, NYP-Weill Cornell, New York, New York, United States
  • Dadhania, Darshana M., NYP-Weill Cornell, New York, New York, United States
Background

The Covid-19 pandemic has had significant impact on the ESKD population with reduction in kidney transplantation due to decreased organ availability and temporary cessation of transplant procedures. To better understand the impact on patients with ESKD, we compared the outcomes of Covid-19 positive patients on the Waitlist with those with a functioning kidney transplant.

Methods

Our center developed a dashboard and active surveillance of Waitlisted and Kidney transplant recipients tested for SARS-CoV-2. From 3/13/20 to 5/20/20, we identified 55 Waitlisted patients who tested positive for SARS-CoV-2, and compared their clinical characteristics and outcomes with those post kidney transplant. Primary outcomes included hospitalization and mortality rates.

Results

Presenting symptoms and hospitalization rates were similar in waitlisted ESKD and kidney transplant patients with Covid -19. Azithromycin and doxycycline use was similar in both groups. Hydroxychloroquine use was more frequent in kidney transplant patients (62% vs 36%), as were other experimental therapies. Mortality was greater in waitlisted ESKD compared to kidney transplant patients (29% vs 13). Of the waitlisted ESKD patients who died, most were males, Black or Hispanic, and 81% had T2DM and/or HTN as the cause of their ESKD. None of the non-hospitalized patients died in either group.

Conclusion

Waitlisted ESKD patients on dialysis with Covid-19 are comparatively at higher risk for mortality compared to kidney transplant recipients with Covid-19 despite similar demographics and similar burden of comorbidities. Whether the ability of immunosuppressive therapy to prevent the cytokine storm contributed to better survival among kidney transplant recipients remains to be determined.