A kidney transplant recipient with COVID-19: utility of a prognostication score

Adrogué, A. H.; Mithani, F.; Ibrahim, H. N.; Schwartz, M.; Gaber, L.; Hebert, S. A.; Adrogué, H. E.

Background Cytokine release storm (CRS) is a potentially fatal, hyperinflammatory condition common to both COVID-19 and reactive hemophagocytic histiocytosis (rHLH). We present our experience with the use of a diagnostic score, developed for rHLH, in a kidney transplant recipient hospitalized with COVID-19. Methods We applied the H-Score to risk-stratify our patient to help predict his hospital course. This study was exempt from requiring specific IRB approval, but met all the criteria required by our institution for this type of study and report including consent from the patient. Results The calculated H-Score for our patient fell below the diagnostic cut-off value for rHLH. Since rHLH is characterized by CRS, we expected him to have a milder hospital course with COVID-19. Correlating with his below cut-off H-score, the patient had a more benign than expected hospital course. Conclusion Since this is only a single case, we plan to retrospectively review a series of patients to validate our initial experience: that a low H-Score may correlate with a milder hospital course in kidney transplant patients with COVID-19.