Abstract: TH-PO963
COVID-19 Mortality in Kidney Transplant Recipients: Analysis of Risk Factors
Session Information
- COVID-19: Vaccines and Outcomes ESRD/KTR
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Turk, Michael, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
- Alhuneafat, Laith, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
- Rizvi, Ali Waris, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
- Gupta, Naman, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
- Barnett, Katherine, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
- Gutta, Ramya, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
- Mealy, Shane, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
- Rana, Tabeer, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
- Shah, Aaisha, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
- Sharma, Alisha, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
- Osman, Omar, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
- Sureshkumar, Kalathil K., Allegheny Health Network, Pittsburgh, Pennsylvania, United States
Background
Mortality rates for COVID-19 infection vary widely. Immunocompromised patients in general have worse outcomes. We aimed to evaluate kidney transplant recipients (KTRs) who were admitted for COVID-19 infection and investigate patient specific factors or comorbidities that may have influenced mortality rates.
Methods
In this retrospective study, we identified KTRs who developed COVID-19 infection between March 2020 and January 2022 within our integrated health network. Through chart review, patient characteristics were collected and stratified by 90-day mortality.
Results
Out of 114 KTRs hospitalized with COVID-19 infection, 24 (21.0%) died during admission, and another 7 died within 90 days of admission bringing total 90-day mortality to 31/114 (27.2%). Among the114 hospitalized patients, 53 (46.5%) had received at least one prior COVID-19 vaccine dose including 35 who received two doses and 9 who received ≥3 doses. KTRs who survived following COVID-19 hospitalizations were significantly younger and were more likely to be vaccinated (Table).
Conclusion
Approximately 1 out of 4 KTRs admitted for COVID-19 infection died within 90-days. Older age was a mortality risk factor and vaccination conferred protection against mortality in these immunocompromised patients. Our study highlights the importance of vaccination in these patients. Relatively small sample size likely limited identification of other potential risk factors for mortality in our analysis.
Patient characteristics
| Variables | Overall (n=114) | Survived (n=83) | Deceased (n=31) | p-value |
| Age | 61.2 ± 11.6 | 58.7 ± 11.0 | 68.0 ± 10.5 | <0.001 |
| Female sex | 46 (40%) | 30 (36%) | 16 (52%) | 0.13 |
| White race | 72 (63%) | 53 (64%) | 19 (61%) | 0.41 |
| Black race | 37 (33%) | 27 (33%) | 10 (32%) | 0.41 |
| Body mass index | 29.9 ± 7.2 | 30.3 ± 6.7 | 28.7 ± 8.6 | 0.28 |
| Hypertension | 106 (93%) | 76 (92%) | 30 (97%) | 0.33 |
| Diabetes | 58 (51%) | 41 (49%) | 17 (55%) | 0.61 |
| CAD | 35 (31%) | 23 (28%) | 12 (39%) | 0.26 |
| Donor type: Deceased | 83 (73%) | 57 (69%) | 26 (84%) | 0.11 |
| Donor type: Living | 31 (27%) | 26 (31%) | 5 (16%) | 0.11 |
| IS regimen: MMF | 84 (74%) | 59 (71%) | 25 (81%) | 0.30 |
| IS regimen: Steroids | 59 (52%) | 45 (54%) | 14 (45%) | 0.39 |
| Vaccinated (at least 1 dose) | 53 (46%) | 43 (52%) | 10 (32%) | 0.06 |
CAD=coronary artery disease; IS= immunosuppression