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Abstract: PO0765

COVID-19 and Kidney Transplantation: Results from the TANGO International Transplant Consortium

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Riella, Leonardo V., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Sarvode mothi, Suraj, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Akalin, Enver, Montefiore Medical Center, Bronx, New York, United States
  • Cravedi, Paolo, Mount Sinai Health System, New York, New York, United States

Group or Team Name

  • TANGO Consortium
Background

Chronic immunosuppression and comorbidities may expose kidney transplant recipients to an increased risk of developing critical coronavirus disease 2019 (COVID-19), but data in transplantation have been limited so far to single centers. To determine the clinical presentation, outcomes, and mortality risk factors in transplant patients with COVID-19, we analyzed retrospective data from a large international transplant consortium (TANGO Study).

Methods

Retrospective cohort study included kidney transplant recipients admitted with COVID-19 in 11 centers participating in the international TANGO consortium. We included all adult (>18 yeas) kidney transplant recipients with a functioning kidney allograft who were admitted to a hospital between March-April, 2020. Epidemiological, demographic, clinical, laboratory, treatment, and outcome data were extracted from electronic medical records using an ad hoc designed data collection form.

Results

Among 9,697 kidney transplant recipients followed at 11 transplant centers, 145 (1.5%) were hospitalized due to COVID-19. 65% were male and more than half were over 60 years old (55%). Median time since transplant was 5 years (2-10) and only 16% were transplanted less than one year from the presentation. Prevalent comorbidities included hypertension (95%), obesity (41%), heart disease (25%) and lung disease (19%). Common symptoms at the onset of illness were fever and dyspnea (71%), followed by myalgia (54%) and diarrhea (35%). Management of anti-rejection therapy varied across centers: antimetabolites were withdrawn in 69% of patients and calcineurin inhibitor in 26%. Other treatments used during hospitalization included hydroxychloroquine (83%), antibiotics (76%), tocilizumab (13%) and antivirals (10%). During a median follow-up of 13 days (IQR: 7 - 21) after diagnosis of COVID-19, mortality was 30% and occurred at a median 10 (5-16) days after admission. Acute kidney injury (AKI) occurred in 46% and respiratory failure requiring intubation in 29% of cases. No rejection events were observed.

Conclusion

Our large international consortium indicates that kidney transplant recipients with COVID-19 have increased mortality (30%) upon hospitalization compared to the general population with a high rate of AKI (46%) and significant respiratory failure (29%).