A Comparison Study of Coronavirus Disease 2019 Outcomes in Hospitalized Kidney Transplant Recipients

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can infect any human host, but kidney transplant recipients (KTR) are considered more susceptible on the basis of previous experience with other viral infections. We evaluated rates of hospital complications between SARS-CoV-2–positive KTR and comparator groups. Methods We extracted data from the electronic health record on patients who were hospitalized with SARS-CoV-2, testing at six hospitals from March 4 through September 9, 2020. We compared outcomes between SARS-CoV-2–positive KTR and controls: SARS-CoV-2–positive non-KTR, SARS-CoV-2–negative KTR, and SARS-CoV-2–negative non-KTR. Results Of 31,540 inpatients, 3213 tested positive for SARS-CoV-2. There were 32 SARS-CoV-2–positive and 224 SARS-CoV-2–negative KTR. SARS-CoV-2–positive KTR had higher ferritin levels (1412; interquartile range, 748–1749 versus 553; interquartile range, 256–1035; P Conclusions Hospitalized SARS-CoV-2–positive KTR had a high rate of mortality and hospital complications, such as requiring ventilation, vasopressor use, and AKI. Additionally, they had higher odds of hospital complications compared with SARS-CoV-2–positive non-KTR after adjusting for Elixhauser score, Black race, and baseline eGFR. Future studies with larger sample size of KTR are needed to validate our findings.