• Sophie Caillard, Nathalie Chavarot, Hélène Francois, Marie Matignon, Clarisse Greze, Nassim Kamar, Philippe Gatault, Olivier Thaunat, Tristan Legris, Luc Frimat, Pierre F Westeel, Valentin Goutaudier, Mariam Jdidou, Renaud Snanoudj, Charlotte Colosio, Antoine Sicard, Dominique Bertrand, Christiane Mousson, Jamal Bamoulid, Christophe Masset, Antoine Thierry, Lionel Couzi, Jonathan M Chemouny, Agnes Duveau, Valerie Moal, Gilles Blancho, Philippe Grimbert, Antoine Durrbach, Bruno Moulin, Dany Anglicheau, Yvon Ruch, Charlotte Kaeuffer, Ilies Benotmane, Morgane Solis, Yannick LeMeur, Marc Hazzan, Francois Danion, and French SOT COVID Registry.
• Department of Nephrology and Transplantation, Strasbourg University Hospital, INSERM, UMR-S 1109, Strasbourg, France.
• Am. J. Transplant. 2021 Mar 1; 21 (3): 1295-1303.

AbstractThere are no studies which have compared the risk of severe COVID-19 and related mortality between transplant recipients and nontransplant patients. We enrolled two groups of patients hospitalized for COVID-19, that is, kidney transplant recipients (KTR) from the French Registry of Solid Organ Transplant (n = 306) and a single-center cohort of nontransplant patients (n = 795). An analysis was performed among subgroups matched for age and risk factors for severe COVID-19 or mortality. Severe COVID-19 was defined as admission (or transfer) to an intensive care unit, need for mechanical ventilation, or death. Transplant recipients were younger and had more comorbidities compared to nontransplant patients. They presented with higher creatinine levels and developed more episodes of acute kidney injury. After matching, the 30-day cumulative incidence of severe COVID-19 did not differ between KTR and nontransplant patients; however, 30-day COVID-19-related mortality was significantly higher in KTR (17.9% vs 11.4%, respectively, p = .038). Age >60 years, cardiovascular disease, dyspnea, fever, lymphopenia, and C-reactive protein (CRP) were associated with severe COVID-19 in univariate analysis, whereas transplant status and serum creatinine levels were not. Age >60 years, hypertension, cardiovascular disease, diabetes, CRP >60 mg/L, lymphopenia, kidney transplant status (HR = 1.55), and creatinine level >115 µmol/L (HR = 2.32) were associated with COVID-19-related mortality in univariate analysis. In multivariable analysis, cardiovascular disease, dyspnea, and fever were associated with severe disease, whereas age >60 years, cardiovascular disease, dyspnea, fever, and creatinine level>115 µmol/L retained their independent associations with mortality. KTR had a higher COVID-19-related mortality compared to nontransplant hospitalized patients.© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.

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