Patients with end-stage kidney disease (ESKD) on a kidney transplant waiting list who have contracted COVID-19 have higher hospitalization and death rates compared with kidney transplant recipients (KTRs) with COVID-19, despite having similar comorbidities, researchers concluded in a poster presented at the American Society of Nephrology’s Kidney Week 2020 Reimagined virtual conference.1

Thalia Salinas, MD, of the Division of Nephrology and Hypertension at Weill Cornell Medicine in New York, New York, and colleagues studied 136 patients with COVID-19: 80 adult kidney transplant recipients and 56 patients with ESKD waitlisted for a kidney transplant. The patients tested positive for SARS-CoV-2, the novel coronavirus that causes COVID-19, from March 13 to May 20, 2020. The hospitalization rate was significantly higher among the waitlisted patients compared with the transplant recipients (82% vs 65%), Dr Salinas and colleagues reported in a poster presentation. The waitlisted patients also had a significantly higher case fatality rate (34% vs 16%).

Waitlisted patients and transplant recipients had similar median follow-up durations: 77 and 78 days, respectively. Being on a transplant waitlist was independently and significantly associated with a 2.7-fold increased risk of mortality.

It remains unclear whether immunosuppressive drug treatments that kidney transplant recipients received contributed to their better survival, according to the investigators. They noted that in the RECOVERY (Randomized Evaluation of COVID-19 Therapy) trial, corticosteroid treatment reduced mortality in patients with severe COVID-19.2


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“Kidney transplantation during the COVID-19 pandemic may be a reasonable treatment option,” they concluded.

References

  1. Salinas T, Craig-Schapiro R, Lubetzky M, et al. Deleterious impact of COVID-19 on patients waitlisted for kidney transplantation. Presented at: Kidney Week 2020 Reimagined, October 19-25. Poster PO0772.
  2. The RECOVERY Collaborative Group. Dexamethasone in hospitalized patients with Covid-19—Preliminary report. Published online July 17, 2020. N Engl J Med. doi:10.1056/NEJMoa2021436