Clinical characteristics and risk factors for severe COVID‐19 in hospitalized kidney transplant recipients: A multicentric cohort study

Favà , A; Cucchiari, D; Montero, N; Toapanta, N; Centellas, J; Vila‐Santandreu, A; Coloma, A; Meneghini, M; Manonelles, A; Sellarés, J; Torres, I; Gelpi, R; Lorenzo, I; Ventura‐Aguiar, P; Cofan, F; Torregrosa, V; Perelló, M; Facundo, C; Seron, D; Oppenheimer, F; Bestard, O; Cruzado, JM; Moreso, F; Melilli, E

Kidney transplant recipients might be at higher risk for severe coronavirus disease 2019 (COVID‐19). However, risk factors for relevant outcomes remain uncertain in this population. This is a multicentric kidney transplant cohort including 104 hospitalized patients between Mar 4 and Apr 17, 2020. Risk factors for death and acute respiratory distress syndrome (ARDS) were investigated, and clinical and laboratory data was analyzed. The mean age was 60 years. Forty‐seven patients (54.8%) developed ARDS. Obesity was associated to ARDS development (OR 2.63; p=0.04). Significant age differences were not found among patients developing and not developing ARDS (61.3yr vs 57.8yr, p=0.16). Seventy‐six (73%) patients were discharged while 28 (27%) died. Death was more common among the elderly (55yr and 70.8yr, p<0.001) and those with preexisting pulmonary disease (OR 2.89 , p=0.009). At admission, higher baseline lactate dehydrogenase (257 IU/ml vs 358 IU/ml, p=0.001) or ARDS conferred higher risk of death (HR 2.09, p=0.044). In our cohort, ARDS was equally present among young and old kidney recipients. However, the elderly might be at higher risk of death, along with those showing higher baseline LDH at admission.