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Coronavirus Disease 2019 in Kidney Transplant Recipients: Single-Center Experience and Case-Control Study

Anna Hardesty1, Aakriti Pandita2, Kendra Vieira2

  • 1Department of Internal Medicine, Residency, Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Transplantation Proceedings
|February 12, 2021
PubMed

Insights

Kidney transplant recipients (KTR) with COVID-19 had outcomes comparable to non-transplant patients, but experienced more bacterial infections. Immunosuppressant drug levels were often high in these KTR.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Transplantation

Background:

  • Kidney transplant recipients (KTR) are a high-risk group for COVID-19 complications.
  • Limited data exists on immunosuppressant drug levels and secondary infections in KTR with COVID-19.

Purpose of the Study:

  • To describe the clinical course of COVID-19 in KTR.
  • To compare outcomes between hospitalized KTR and non-transplant controls.

Main Methods:

  • Retrospective case series of KTR diagnosed with COVID-19.
  • Comparison of clinical outcomes between KTR and age/sex-matched non-transplant controls.
  • Analysis of immunosuppressant drug levels and secondary infection rates.

Main Results:

  • No significant difference in length of stay or clinical outcomes between KTR and controls.
  • Elevated tacrolimus or sirolimus levels (>10 ng/mL) in 67% of KTR.
  • Higher incidence of bacterial infections in KTR (36.3%) compared to controls (6.8%).

Conclusions:

  • COVID-19 outcomes in KTR were comparable to non-transplant patients in this cohort.
  • High calcineurin or mTOR inhibitor levels were observed in KTR.
  • Bacterial infections were more frequent in KTR.
Abstract

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