COVID-19 in kidney transplant recipients: what have we learned one year later? A cohort study from a tertiary center

Introduction: Kidney transplant (KT) recipients have a high risk for adverse outcomes from infections, such as CO-VID-19. Methods: We have retrospec-tively reviewed all KT recipients with documented COVID-19 between March 1, 2020, and March 15, 2021, and ana-lyzed patients' characteristics, clinical course, treatment, and outcomes. Results: We identified 123 patients, 72% were male, with a mean age of 54.5 +/- 13.0 years. Twenty percent were asymptomatic, 7% had a nosocomial transmission, and 36% of the remainder required hospitalization. Almost all admitted patients received oxygen, 30% required invasive mechani-cal ventilation (IMV), more than a half had acute kidney injury, with 10% requir-ing dialysis, and 20% died. Incidence was comparable to that of the Portuguese pop-ulation, but the mortality rate was almost four times higher (SMR of 3.768 (95% CI:1.723-7.154). Higher body mass in-dex (OR 1.275, P=0.001), lower baseline graft function (OR 0.968, P=0.015), and nosocomial transmission (OR 13.836, P=0.019) were associated with oxygen de-mand, whereas female gender (OR 3.801, P=0.031) and lower baseline kidney graft function (OR 0.955, P=0.005), but not body mass index, were associated with IMV and/or death. Conclusion: Mortality rate in KT patients was higher than in the general population and lower baseline kidney function was the most consistent marker for adverse outcomes.