Obesity Increases COVID-19 Death Risk in Kidney Transplant Recipients

Obesity, Black and Hispanic race, and high functional status increase the risk of dying from COVID-19 among kidney transplant recipients (KTRs), data presented at the virtual 2021 American Transplant Congress suggest.

In a study of 1804 KTRs in the 11 United Network for Organ Sharing (UNOS) regions who died, Karthik Goli, MD, of the Baylor College of Medicine in Houston, Texas, and colleagues found that patients who had a body mass index (BMI) of 30 kg/m² or higher had significant 1.70-fold increased odds of death from COVID-19 than those with a lower BMI. Black and Hispanic race were significantly associated with 2.9- and 3.7-fold increased odds of COVID-19-related death, respectively, compared with White race. KTRs who had a functional status of 90% at follow-up had significant 2.2-fold increased odds of dying from COVID-19 compared with those who had a lower functional status.

Patients aged 65 years or older had significant 41% decreased odds of dying from COVID-19 compared with younger patients, according to the investigators.

Dr Goli, who presented study findings in a video presentation, offered explanations for their findings. Obese KTRs tend to be at higher risk for a COVID-19-related death because of multiple comorbidities, they noted. Dr Goli offered explanations for the study’s findings. Obese KTRs tend to be at higher risk for a COVID-19-related death because of multiple comorbidities, he said. “Additionally, patients who have higher functional status and are thus more active may be more likely to get exposed to COVID-19 while on immunosuppression. In contrast, the elderly who are under immunosuppression may be more likely to remain at home and limit exposure to COVID-19.”

The investigators also reported variation among UNOS regions in the percentage of deaths due to COVID-19, which ranged from 11.1% in region 8 (Colorado, Iowa, Kansas, Missouri, Nebraska, and Wyoming) to 57.5% in region 9 (New York State and western Vermont).

Reference

Goli K, Galvan NT, Cotton R, Goss JA, O’Mahony A, Rana A. Covid-19 related deaths across the U.S. in kidney transplant recipients. Presented at: ATC 2021 virtual conference held June 4-9. Abstract 124.