*Purpose: Kidney transplant recipients are a unique cohort in regard to SARS-CoV 2 susceptibility and clinical course, owing to their immunosuppressed state and propensity for kidney injury. The purpose of this study is to ascertain if, in kidney transplant recipients, SARS-CoV 2 infection impacts long term renal allograft function. Further, it also aims to identify prognostic indicators that accurately predict any impact on graft function.

*Methods: This retrospective, single-center study included kidney transplant recipients with a positive SARS-CoV-2 PCR at Northwestern Memorial Hospital from January 1, 2020 to June 30, 2020. Fifty-three patients met the inclusion criteria. Each patient’s clinical disease severity was ranked according to the WHO Ordinal Scale for SARS-CoV-2 Clinical Improvement, and the study population was divided into three groups based on disease severity {mild disease (ordinal scale of 0-2): n=11, moderate disease (ordinal scale of 3-4): n=29, severe disease (ordinal scale of 5-8): n=13). The primary endpoint was change in estimated GFR (eGFR) from baseline kidney function prior to the positive SARS-CoV 2 PCR to 90 days after the positive test. Relevant demographic and clinical data was also collected. A one-way ANOVA test was employed to compare the 3 groups, and a Welch’s T-test assessed differences between sets of two cohorts.

*Results: Change in eGFR from baseline kidney function prior to infection to 90 days after the first positive SARS-CoV 2 test was +1.76 %, -17.5 % and -23.16 % the mild, moderate and severe disease groups respectively (Figure 1). There was a significant decline in kidney function in the moderate and severe disease cohorts as compared to the mild disease cohort, with respective p values of p=0.0002 and p=0.021. Relative to the mild disease cohort, the moderate and severe disease cohorts also demonstrated significantly increased risk of developing AKI, both with p values of P=0.0001 (Figure 2).

*Conclusions: Clinically severe SARS-CoV 2 infection is associated with greater risk of acute kidney injury and greater decline in renal allograft function at 90 days post infection, compared to mild disease. These results highlight the importance of closely monitoring renal allograft function, in kidney transplant patients with SARS- CoV 2 infection. Furthermore, there is a need for additional studies to determine longer term allograft outcomes.

« Back to 2021 American Transplant Congress