22% died, 48% developed acute kidney injury, 28% needed intensive care unit admission, 35% had acute respiratory distress syndrome, 23% needed invasive ventilation. Univariate analysis revealed that advanced age, obesity and diabetes were associated with severe infection and mortality. Laboratory abnormalities at admission including higher C reaction protein, D-Dimer, lactate dehydrogenase, procalcitonin, and lower lymphocyte also increased the risk of death. Initial use of MMF contributed to severe infection, and tacrolimus led to more deaths. Further, calcineurin inhibitors withdrawal, high dose steroids, Tocilizumab, ICU-admission, and invasive ventilation were associated with mortality.
On the other hand - R. Prashar and colleagues (Detroit) identified surprisingly three Living Kidney Donors with previously resolved COVID infection and observed an uncomplicated immediate post-donation course. The Recipients tend to do well. Questions remain regarding optimal timing of donation and transplant after COVID-resolution, to minimize risk of transmission through tissue, even with negative nasopharyngeal PCR.
A. Santeusanio and Colleagues (New York) described short-term outcomes of 10 patients with prior Coronavirus Disease: The patients with prior PCR confirmed COVID-19 were considered candidates for kidney transplantation if they were at least four weeks post-infection, had resolution of symptomes, and had one negative nasopharyngeal PCR swab specimen. Standard doses of induction and maintenance immunosuppression were administered. The authors describe similar short-term outcomes when compared with COVID-19 naive patients.