*Purpose: We aimed to investigate the mortality from SARS-CoV-2 in kidney transplant recipients in the Bronx, New York, one of the epicenters of the pandemic over the period of the pandemic.

*Methods: Between March 16 and November 30, 2020, 158 patients were tested positive by SARS-CoV-2 RT-PCR.

*Results: 94 (59.5%) were male, at a median age of 62 years old (IQR: 51-71), predominantly Hispanic (54.4%) and African American (29.7%). 127 patients were admitted to the hospital and 29 were observed at home. 75.3% received a deceased-donor renal transplant, 57% received anti-thymocyte globulin induction. Most patients were on triple immunosuppression (94.3% on calcineurin inhibitors, 86.7% on anti-metabolite, 96.7% on prednisone). Hypertension was present in 96.2%, diabetes mellitus in 62.7%, heart disease in 19.6% and lung disease in 8.9% of the patients. The figure shows the number of RT-PCR positivity and mortality over the course of the pandemic starting on March 16, 2020. A total of 50 (31.6%) died as of November 30, 2020. The mortality rate was 40% (17/43) in patients diagnosed between March 16 and 31,2020, 39% (23/59) in patients diagnosed between April 1 and 15,2020 and 29% (7/24) in patients diagnosed between April 16 and 30, 2020. Since May 1^st 2020, the mortality rate has significantly decreased to 9% (3/32).

*Conclusions: In summary, mortality from SARS-CoV-2 infection in kidney transplant recipients was higher during the first 6 weeks of the pandemic and has significantly decreased over time. This could be explained by initial exposure of the patients with higher viral load due to lack of personal protection and social distancing due to the fact that there is no current proven treatment for SARS-CoV-2 infection and clinical approach to patients has not been changed since the beginning of the pandemic.

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