Early Description of Coronavirus 2019 Disease in Kidney Transplant Recipients in New York

J Am Soc Nephrol. 2020 Jun;31(6):1150-1156. doi: 10.1681/ASN.2020030375. Epub 2020 Apr 21.

Abstract

Background: The novel SARS-CoV-2 virus has caused a global pandemic of coronavirus disease 2019 (COVID-19). Although immunosuppressed individuals are thought to be at an increased risk of severe disease, little is known about their clinical presentation, disease course, or outcomes.

Methods: We report 15 kidney transplant recipients from the Columbia University kidney transplant program who required hospitalization for confirmed COVID-19, and describe their management, clinical course, and outcomes.

Results: Patients presented most often with a fever (87%) and/or cough (67%). Initial chest x-ray most commonly showed bilateral infiltrates, but 33% had no acute radiographic findings. Patients were managed with immunosuppression reduction and the addition of hydroxychloroquine and azithromycin. Although 27% of our patients needed mechanical ventilation, over half were discharged home by the end of follow-up.

Conclusions: Kidney transplant recipients with COVID-19 have presentations that are similar to that of the general population. Our current treatment protocol appears to be associated with favorable outcomes, but longer follow-up of a larger cohort of patients is needed.

Keywords: COVID-19; Epidemiology and outcomes; kidney transplantation; transplant outcomes.

MeSH terms

  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / therapy
  • Adult
  • Aged
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / therapy*
  • Female
  • Humans
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / therapy*
  • Respiration, Artificial
  • SARS-CoV-2