Comparative Analysis of Kidney Transplant Recipients with Severe Acute Respiratory Syndrome Coronavirus 2 Compared with Nonkidney Transplant Recipients: A Largest Single-center Report from the Second Wave of Coronavirus Disease 2019 Pandemic in South East Asia.

Outcomes of severe acute respiratory syndrome coronavirus 2 in kidney transplant recipients (KTR) compared with matched cohort are certainly lacking for different pandemic waves and geographic regions. In this single-center retrospective study of coronavirus disease-2019 (COVID-19) cases admitted during March 26, 2021 to June 7, 2021, a propensity-matched analysis in a 1:1 ratio was performed to compare the clinical profile and outcomes between KTR and non-KTR. A Cox proportional hazard model from the whole study population to analyze risk factors for severe disease and mortality was calculated. We identified 1052 COVID-19 cases, of which 107 (10.1%) were KTR. In propensity-matched analysis, KTR had higher fever (81.6 % vs. 60%; P = 0.01), lymphopenia (30% vs. 11.7%; P = 0.02), higher neutrophil-to-lymphocyte ratio (43.3% vs. 25%; P = 0.05), and acute kidney injury (66.6% vs. 36.7%; P = 0.001). In Kaplan-Meier survival analysis, there was no difference in mortality or severity of COVID-19. In Cox hazard proportional analysis, the European cooperative oncology group (ECOG) score of 1 to 2 [Hazard ratio (HR) 95% lower confidence interval (CI), upper CI = 4.9 (1.8-13.5); P <0.01], ECOG of >2 [HR = 20 (7.5, 54.7); P <0.01] and waitlisted status [HR = 1.9 (1.1-3.3); P = 0.02] was associated with significant mortality. Kidney transplantation [HR = 0.8 (0.47-1.44); P = 0.5] was not associated with mortality in the analysis. In our report, kidney transplantation status had a different spectrum but was not found to be independently associated with COVID-19 severity or mortality.

A Propensity-Matched Analysis of COVID-19 in Kidney Transplant Recipients Compared With Non-Kidney Transplant Patients: A Single-Center Report From India.

OBJECTIVES: Comparisons of COVID-19 incidence between kidney transplant recipients and patients who did not receive kidney transplant are underexplored in various geographic regions. MATERIALS AND METHODS: This Indian, single-center, retrospective study analyzed COVID-19 data of patients hospitalized between May 12, 2020, and January 11, 2021. A propensity matching score was used to compare outcomes between the 2 groups. We also used multivariable Cox proportional hazard analyses to assess association of kidney transplantation with mortality. RESULTS: Of the 1627 COVID-19 cases, 179 were kidney transplant recipients and 1448 were not kidney transplant patients (control group). Ofthe 436 reported in-hospital deaths, 20 (11.1%) were in the kidney transplant group and 416 (28.7%) were in the control group. Propensity matching identified 98 kidney transplantrecipients and167 controlpatients. InKaplanMeier survival plots for these patients, there was no statistical difference in mortality (log-rank, Mantel Cox test; P = .07) or severity (log-rank, Mantel Cox test; P = .07) with regard to COVID-19. In Cox analysis, age groups from 61 to 70 years (hazard ratio = 1.5; 95% CI, 1.0-2.2; P = .04), 71 to 80 years (hazard ratio = 1.64; 95% CI, 1.0-2.5; P = .02), and >80 years (hazard ratio = 1.91; 95% CI, 1.1-3.1; P = .01)were associatedwith statistically significant greater mortality.Having a kidney transplant (hazard ratio = 0.43; 95% CI, 0.3-0.7; P = 0.001) was not associated with mortality. CONCLUSIONS: In our analysis, age was the most important predictor of mortality. Kidney transplant status was not found to have an independent association with mortality and severity.