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Abstract: TH-PO956

Outcomes in Kidney Transplant Recipients With COVID-19 Illness in the Era of Vaccines

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Lamba, Perola, Weill Cornell Medicine, New York, New York, United States
  • Stryjniak, Gabriel J., Weill Cornell Medicine, New York, New York, United States
  • Lee, John Richard, Weill Cornell Medicine, New York, New York, United States
  • Muthukumar, Thangamani, Weill Cornell Medicine, New York, New York, United States
  • Salinas, Thalia, Weill Cornell Medicine, New York, New York, United States
  • Sawinski, Deirdre L., Weill Cornell Medicine, New York, New York, United States
  • Dadhania, Darshana M., Weill Cornell Medicine, New York, New York, United States
Background

Kidney transplant recipients (KTRs) are risk for severe complications from COVID-19 illness due to immunosuppression. Predating COVID-19 vaccines our center reported AKI in 39% & death in 13% of KTRs. Here we describe the impact of COVID-19 on allograft & patient outcomes in KTRs with & without COVID-19 vaccination. We also compare outcomes in KTRs with & without response (SARS-CoV2 spike/anti-S antibody) to COVID-19 vaccine.

Methods

This is a retrospective cohort analysis of 142 KTRs identified with COVID-19 illness between 7/1/21 and 2/10/22. We collected data on patient demographics, COVID19 vaccine doses, anti-S levels & clinical outcomes including graft dysfunction, hospitalization, ICU admission & death.

Results

Of 142 KTRs in our cohort, 113 (80%) were fully vaccinated (+/- booster) and 29 (20%) were un or partially vaccinated. 60 of 113 vaccinated KTRs were tested for anti-S levels between COVID19 vaccination & illness: 68% tested positive and 32% negative for anti-S Ab.

Allograft dysfunction & hospitalization were less frequent in fully vaccinated vs unvaccinated KTRs (Fig.1). There was no difference between the two in terms of ICU admission and death (22 vs 18%, p=0.7).

Among vaccinated KTRs, there was a trend towards less graft dysfunction in positive vs. negative anti-S (15% vs. 33% p=0.15). No differences were observed between anti-S levels and hospitalization (23% vs 26% p=0.7), ICU admission (11 vs 60% p=0.07) and death (11 vs 20% p=0.65).

Conclusion

In our cohort, kidney allograft dysfunction and hospitalization was less common vaccinated vs unvaccinated KTRs with COVID-19. Additionally, there is a trend towards lower graft dysfunction in those with positive anti-S Ab. No significant differences were observed in death and ICU admissions with vaccination or positive anti-S. Vaccination to COVID-19 and maintaining positive anti-S Ab (with boosters or monoclonal Ab) are important in preventing graft dysfunction and hospitalization following COVID-19.