Clinical features and outcomes of kidney transplant recipients with COVID-19
| Clinical Features and Outcomes | All Patients, n=66 | Invasive Mechanical Ventilation, n=15 | No Invasive Mechanical Ventilation, n=51 |
|---|---|---|---|
| Features at diagnosis | |||
| Clinical presentation, no. (%) | |||
| Fever | 51 (77) | 12 (80) | 39 (76) |
| Cough | 38 (58) | 11 (73) | 27 (53) |
| Dyspnea (exertional or rest) | 26 (39) | 12 (80) | 14 (27) |
| Diarrhea | 17 (26) | 2 (13) | 15 (29) |
| Anosmia/ageusia | 7 (11) | 0 (0) | 7 (14) |
| Laboratory testsa | |||
| White blood cell count, 1000/µl, median (range)a | 5.9 (1.6–14.2) | 7.4 (2.6–14.2) | 5.3 (1.6–13.2) |
| Absolute lymphocyte count, /µl | 528 (80–1300) | 473 (80–1180) | 548 (169–1300) |
| C-reactive protein, mg/L | 115 (0–335) | 159 (18–316) | 96 (0–335) |
| Chest x-ray/pulmonary CT scan,a no. (%) | |||
| Multifocal/bilateral patchy opacities | 38/56 (68) | 12/13 (92) | 26/43 (60) |
| Lobar opacities | 3/56 (5) | 1/13 (8) | 2/43 (5) |
| No acute findings | 15/56 (27) | 0/13 (0) | 15/43 (35) |
| Immunosuppressive treatment, no. (%) | |||
| MMF/MPA/AZA | 61 (92) | 13 (87) | 48 (94) |
| CNI | 57 (86) | 14 (93) | 43 (84) |
| Belatacept | 6 (9) | 1 (7) | 5 (10) |
| Steroids | 55 (83) | 13 (87) | 42 (82) |
| Treatment and outcome | |||
| Change in immunosuppression, no. (%) | |||
| Discontinued only MMF/MPA/AZA | 38/61 (62) | 13 (100) | 25/48 (52) |
| Discontinued only CNI | 2/57 (4) | 2/14 (14) | 0 |
| Belatacept infusion postpone | 1/6 (17) | 0 | 1/5 (20) |
| No change | 24 (36) | 2 (13) | 22 (43) |
| Discontinued all immunosuppression | 1 (2) | 1 (7) | 0 |
| Anti–COVID-19 therapies, no. (%) | |||
| Hydroxychloroquine | 7 (11) | 4 (27) | 3 (6) |
| Tocilizumab | 1 (2) | 0 (l0) | 1 (2) |
| Eculizumab | 2 (3) | 0 (0) | 2 (4) |
| Outcomes, no. (%) | |||
| AKI | 28 (42) | 13 (87) | 15 (29) |
| RRT required | 7 (11) | 7 (47) | 0 (0) |
| Died | 16 (24) | 11 (73) | 5 (10) |
| Recovery | 50 (76) | 4 (27) | 46 (90) |
Data are displayed as n (%) or median (range). CT, computed tomography; MMF, mycophenolate mofetil; MPA, mycophenolic acid; AZA, azathioprine; CNI, calcineurin inhibitor.
↵a Data recorded in the 60 hospitalized patients, with missing data for two patients in the invasive mechanical ventilation group and two patients in the noninvasive mechanical ventilation group, for patients admitted to other hospitals.