Factors assessed at time of post-transplant risk evaluation associated with COVID-19 disease in patients with kidney transplants: univariate and multivariate analysis
| Factors Associated with COVID-19 Disease in Kidney Transplant Patients | No. of Patients | No. of COVID-19–Positive Patients | Odds Ratio (95% CI) | P Value |
|---|---|---|---|---|
| Factors associated with COVID-19 disease: univariate analysis | ||||
| Recipient characteristics | ||||
| Age, per 1-yr increment | 1216 | 66 | 1.01 (1.00 to 1.04) | 0.15 |
| Sex | ||||
| Women | 439 | 29 | 1 | |
| Men | 777 | 37 | 0.71 (0.43 to 1.17) | 0.17 |
| Ethnicity | ||||
| White | 994 | 42 | 1 | |
| Non-White | 222 | 24 | 2.75 (1.63 to 4.64) | <0.001 |
| Transplant characteristics | ||||
| Donor type | ||||
| Deceased donor | 1053 | 64 | 1 | |
| Living donor | 163 | 2 | 0.19 (0.05 to 0.79) | <0.001 |
| Prior kidney transplant | ||||
| No | 1084 | 58 | 1 | |
| Yes | 132 | 8 | 0.88 (0.41 to 1.88) | 0.69 |
| Time on dialysis before graft per 1-mo increment | 1078 | 66 | 1.00 (1.00 to 1.01) | 0.09 |
| Multiorgan recipient | ||||
| No | 1120 | 62 | 1 | |
| Yes | 96 | 4 | 1.35 (0.48 to 3.79) | 0.57 |
| Time of risk evaluation | ||||
| Time from transplant to evaluation per 1-mo increment | 1216 | 66 | 0.99 (0.99 to 1.00) | 0.02 |
| Functional allograft parameters | ||||
| Recent episode of rejection | ||||
| No | 971 | 54 | 1 | |
| Yes | 245 | 12 | 0.87 (0.46 to 1.66) | 0.68 |
| Serum creatinine per μmol/L increment | 1185 | 66 | 1.00 (1.00 to 1.01) | 0.11 |
| Comorbidities | ||||
| Smoker | ||||
| No | 1060 | 60 | 1 | |
| Yes | 156 | 6 | 0.67 (0.28 to 1.57) | 0.35 |
| Obesity (BMI≥30) | ||||
| No | 1043 | 46 | 1 | |
| Yes | 151 | 20 | 3.31 (1.90 to 5.77) | <0.001 |
| Diabetes | ||||
| No | 926 | 35 | 1 | |
| Yes | 290 | 31 | 3.05 (1.84 to 5.04) | <0.001 |
| Hypertension | ||||
| No | 287 | 8 | 1 | |
| Yes | 929 | 58 | 2.32 (1.10 to 4.92) | 0.02 |
| Asthma and chronic pulmonary disease | ||||
| No | 1138 | 53 | 1 | |
| Yes | 78 | 13 | 4.09 (2.12 to 7.89) | <0.001 |
| Cardiovascular disease | ||||
| No | 1146 | 65 | 1 | |
| Yes | 70 | 1 | 0.24 (0.03 to 1.76) | 0.17 |
| Maintenance immunosuppressive therapies | ||||
| Prednisone | ||||
| No | 368 | 11 | 1 | |
| Yes | 829 | 55 | 2.31 (1.19 to 4.46) | 0.01 |
| Tacrolimus | ||||
| No | 510 | 29 | 1 | |
| Yes | 691 | 37 | 0.94 (0.57 to 1.55) | 0.80 |
| Cyclosporin | ||||
| No | 841 | 46 | 1 | |
| Yes | 360 | 20 | 1.02 (0.59 to 1.74) | 0.95 |
| Mycophenolate mofetil or mycophenolic acid | ||||
| No | 201 | 13 | 1 | |
| Yes | 996 | 53 | 0.81 (0.43 to 1.52) | 0.51 |
| Belatacept | ||||
| No (CNI regimen)a | 1051 | 57 | 0.61 (0.25 to 1.47) | 0.28 |
| Yes | 70 | 6 | 1 | |
| Azathioprine | ||||
| No | 1047 | 58 | 1 | |
| Yes | 150 | 8 | 0.96 (0.45 to 2.05) | 0.92 |
| Factors associated with COVID-19 disease: multivariate model | ||||
| Prednisoneb | ||||
| No | 293 | 11 | 1 | |
| Yes | 741 | 55 | 1.67 (0.87 to 3.47) | 0.15 |
| Ethnicity | ||||
| White | 829 | 42 | 1 | |
| Non-White | 205 | 24 | 2.17 (1.23 to 3.78) | 0.007 |
| Cardiovascular disease | ||||
| No | 970 | 65 | 1 | |
| Yes | 64 | 1 | 0.20 (0.03 to 1.50) | 0.12 |
| Obesity (BMI≥30) | ||||
| No | 900 | 46 | 1 | |
| Yes | 134 | 20 | 2.19 (1.19 to 4.05) | 0.01 |
| Asthma and chronic pulmonary disease | ||||
| No | 964 | 53 | 1 | |
| Yes | 70 | 13 | 3.09 (1.49 to 6.41) | 0.002 |
| Diabetes | ||||
| No | 785 | 35 | 1 | |
| Yes | 249 | 31 | 3.33 (1.92 to 5.77) | <0.001 |
| Time on dialysis before graft per 1-mo increment | 1034 | 66 | 1.01 (0.99 to 1.01) | 0.07 |
OR, odds ratio; BMI, body mass index; CNI, calcineurin inhibitor (cyclosporin or tacrolimus).
↵a Three patients did not take either CNI or belatacept.
↵b The multivariable analysis was restricted to 1034 patients without any missing data for each of the variables included in the final model by the stepwise backward elimination.