ABSTRACT
BACKGROUND: The early effects of coronavirus disease 2019 (COVID-19) on transplantation are dramatic: >75% of kidney and liver programs are either suspended or operating under major restrictions. To resume transplantation, it is important to understand the prevalence of COVID-19 among transplant recipients, donors, and healthcare workers (HCWs) and its associated mortality. METHODS: To investigate this, we studied severe acute respiratory syndrome coronavirus 2 diagnostic test results among patients with end-stage renal disease or kidney transplants from the Johns Hopkins Health System (n = 235), and screening test results from deceased donors from the Southwest Transplant Alliance Organ Procurement Organization (n = 27), and donors, candidates, and HCWs from the National Kidney Registry and Viracor-Eurofins (n = 253) between February 23 and April 15, 2020. RESULTS: We found low rates of COVID-19 among donors and HCWs (0%-1%) who were screened, higher rates of diagnostic tests among patients with end-stage renal disease or kidney transplant (17%-20%), and considerable mortality (7%-13%) among those who tested positive. CONCLUSIONS: These findings suggest the threat of COVID-19 for the transplant population is significant and ongoing data collection and reporting is critical to inform transplant practices during and after the pandemic.
ABSTRACT
Real-time reverse transcriptase polymerase chain reaction (rRTPCR) has been the main method for diagnosis of SARS-CoV-2 infection in the early stages of the COVID-19 pandemic. De-identified results from upper and lower respiratory samples submitted to a reference laboratory demonstrated a positivity rate of 14.9 % (4428 of 29,713 samples tested). Distribution of results by birth year cohort and specimen type suggested general consistency in mean, median and peak values but higher positivity rates in individuals born from 1964 to 1974. Female patients had a significantly lower positivity rate (P < 0.0001), although similar load mean and median values, compared to males. Overall, 15.3 % (676 of 4428 positive results) of positive results had viral loads greater than 8 log10 copies/mL, with occasional samples exceeding 10 log10 copies/mL. These results support quantitative assessment of SARS-CoV-2 viral load in patient testing and efforts to control viral transmission.