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Kidney Week

Abstract: PO0775

Outcomes of COVID-19-Positive Kidney Transplant Recipients

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Katz-Greenberg, Goni, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Yadav, Anju, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Gulati, Rakesh, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Singh, Pooja, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
Background

Kidney transplant recipients (KTR) are at increased risk of infections due to immunosuppression (IS). COVID-19 has posed unique challenges due to its evolving symptomatology and lack of effective treatment options. Current data published about the impact of COVID-19 in KTR comes from severely impacted areas. The aim of our study was to review course and outcomes of KTR at our center.

Methods

Retrospective chart review of KTR diagnosed with COVID-19. Descriptive statistics were summarized as absolute numbers for categorical data and as median with interquartile range (IQR) for skewed distribution.

Results

We had 20 KTR diagnosed with COVID-19. Median age of 53.5 years(47-63), 10 males, and 12 blacks. Median time from KT to presentation was 70.7 months(17.25-158.75), with 1 pt in 1st year post KT. Thirteen (65%) pts were obese with BMI≥30kg/m2, 2 pts had chronic obstructive pulmonary disease, and 5 had cardiac disease.
Most common presenting symptom was cough in 14 pts, followed by fever-13 pts, shortness of breath-9, and diarrhea-6pts. During the study, 15 pts were hospitalized, and 9 of them had chest x-ray findings of bilateral opacities consistent with pneumonia. Inflammatory markers were elevated in all pts but did not correlate with disease outcome. Acute kidney injury was seen in 9 pts, with 3 requiring continuous renal replacement therapy. Four pts required mechanical ventilation.
Ten pts had reduction of their IS. Hydroxychloroquine was used in 11 pts, and azithromycin in 4. Four hospitalized pts received convalescent plasma as part of an ongoing COVID-19 trial in our center. Donors were 4-6 weeks post recovery from confirmed severe acute respiratory syndrome coronavirus 2 infection. Enrollment was offered to pts at high risk of progression to severe disease.
We had 3 deaths, 2 pts remain hospitalized, and the remaining 15 were either discharged or managed as outpatients. Median follow up time from presentation was 25 days(13-38) for the entire cohort.

Conclusion

In our cohort, 45% of patients presented with acute allograft dysfunction highlighting impact of SARS-CoV-2 infection on kidney function. Our center utilized investigational convalescent plasma in 4 pts successfully while the clinical trial outcomes are awaited. Ultimately, the development of a safe and efficacious vaccine targeting SARS-CoV-2 may better equip us to fight this pandemic.