Table 2.
Characteristics of all available reported kidney transplant recipients infected with COVID-19.
| Study; Country | Number | Age; Sex | Years post-Tx; Donor | Comorbidities | Clinical presentation; Max Temp | Initial WBCC, NC, LC (×109/L) | Initial CRP (mg/L) | Baseline Cr (mg/dL)^ | Initial Cr (mg/dL) |
|---|---|---|---|---|---|---|---|---|---|
| Banerjee; UK [12] | #1 | 48;M | 31; deceased | HTN | Cough, Fever, SOB; N/A | N/A | N/A | 3.96 | N/A |
| #2 | 67;F | 1; DBD | HTN, DM | Cough, Fever, SOB, Hypoxia; N/A | 6, N/A, 0.8 | 83 | 1.7 | 2.54; AKI | |
| #3 | 54;F | 0.25; deceased | DM, CMV infection | SOB, Hypoxia; N/A | 11.2, N/A, 0.5 | 329 | 1 | 2.71; AKI | |
| #4 | 65;M | 1.5; deceased | HTN | SOB, Chest pain; N/A | N/A | N/A | 2 | N/A | |
| #5 | 69;F | 0.083; deceased | HTN, DM | SOB, Fever, V/D; 39°C | 9.4, N/A, 0.3 | N/A | 1.9 | N/A | |
| #6 | 54;M | 7; N/A | HTN, HHA | Cough, Fever; 38.5°C | 10, N/A, 4 | N/A | 1.6 | 2.1; AKI | |
| #7 | 45;M | 2.5; N/A | HTN | Fever, Flu-like symptoms, Cough, SOB, Hypoxia; N/A | 5.5, N/A, 0.3 | 198 | 5.1 | 11; AKI | |
| Bartiromo; Italy [3] | #1 | 36; F | 25; deceased | SLS | Cough, Coryza, Fatigue; 36.3°C | N/A, High, Normal | 67 | 1.5 | 1.77 |
| Chen; China [24] | #1 | 49; M | 6; DBD | HTN | Hyporexia, Cough, Fever, SOB; 38.6°C | 3.4, 2.59, 0.4 | 74 | 1.24 | 1.89 |
| Gandolfini; Italy [25] | #1 | 75; M | 10; deceased | COPD, HTN, Obesity, CAD | Fever, SOB, Flu-like symptoms; 37.5°C | 6.5, N/A, 0.8 | 180 | 2.1 | 2.2 |
| #2 | 52; F | 0.66; DCD | HTN | Fever, SOB, D, Flu-like symptoms; 37.5°C | 2.5, N/A, 0.11 | 158 | 1.3 | 2.4; AKI | |
| Guillen; Spain [26] | #1 | 50; M | 4; deceased | HTN, PTLD, SP | Fever, V, Dehydration, Cough, Conjunctivitis, Hypoxia; 38.2°C | 10.5, N/A, 1.8 but developed lymphopenia | 5 | 1.3 | 1.6; AKI |
| Huang; China [27] | #1 | 58; M | 12; N/A | None | Cough, Fever, SOB, Hypoxia; 37.6°C | N/A but developed lymphopenia | N/A | N/A | N/A |
| Ning; China [28] | #1 | 29; M | 1.5; Living | HTN | Fever, Fatigue, Chills, Hyporexia, N/V, Chest tightness, nasal stuffiness, Dizziness, Hematuria; 37.7°C | 11.4, N/A, 1.5 | N/A | N/A | 1.1; AKI |
| Seminari; Italy [29] | #1 | 50; M | 4; N/A | HTN, DM | Cough, Fever; 37.5°C | 3.5, 1.8, 1.2 but developed lymphopenia | 18.6 | N/A | 1.7 |
| Wang; China [30] | #1 | 49; M | 2; N/A | HTN, DM | Fever, Respiratory symptoms; N/A | 7, 6, 0.6 | 22.7 | N/A | 1.4 |
| Zhang; China [31] | #1 | 38; M | 0.5; DCD | None | Cough, Fever; 38.9°C | 4.7, 2.6, 0.6 | 6 | N/A | 1.1 |
| #2 | 64; M | 4; DCD | Bladder cancer | Fever, Anuria, Cough,, SOB, Flu-like symptoms; 38.3°C | 17.6, 16, 0.5 | 337 | N/A | 4.6; AKI | |
| #3 | 37; F | 0.66; DCD | HTN | Cough, Fever; 39°C | 5.6, 3.9, 0.3 | 9.7 | N/A | 1.5 | |
| #4 | 47; M | 1.2; DCD | None | Cough, Fever, Flu-like symptoms; 39.8°C | 4, 2.3, 0.5 | 13.3 | N/A | 1.6 | |
| #5 | 38; M | 3; DCD | HTN, DM | Cough, Fever, Flu-like symptoms; 39.1°C | 6.4, 3.2, 0.9 | 33.7 | N/A | 1.5 | |
| Zhu; China [32] | #1 | 52; M | 12; Living | None | Fatigue, SOB, Chest tightness and pain, N, Hyporexia, Abd.P, Cough, Fever, Headache, Weight loss; 38.9°C | 9, 7, 1.13 but developed lymphopenia | 30 | 1.57 | 1.62 |
| Arpali; Turkey [37] | #1 | 28; F | 0.5; Living | LLS | Fever, Fatigue, Sore throat, Rhinorrhea; 38°C | 3.1, N/A, 0.3 | 5.7 | 0.92 | |
| Billa; USA [38] | #1 | 44; M | 7; deceased | None | SOB; N/A | 2.3 | 2.3; AKI | ||
| Fontana; Italy [39] | #1 | 61; M | 15; deceased | NMZL, PD, NB | Fever, Chills; 38°C | 5.4, 4.2, 1.2 but developed lymphopenia | 41 | 1.5 | 1.9 |
| Hsu; USA [40] | #1 | 39; M | 3; | DCM, DM, HTN, Obesity | Fever, Headache, Sore throat, Cough, SOB, Fatigue, Myalgia, Dizziness, Chills; 38.8°C | 2.5, N/A, 0.2 | 67 | 1 | 0.85 |
| Kates, USA [41] | #1 | 54; M | 20; deceased | HTN, DM, | Fever, Chills, Fatigue, Cough, SOB, N/V/D; 40°C | 6.2, N/A, 2 but developed lymphopenia | 1.9 | 3.4; AKI | |
| Johnson; USA [42] | #1 | 57; M | 0.66; deceased | None | Fever, Chills, Hyporexia, Abd. bloating, Back pain, Fatigue, Myalgia, SOB, Anorexia, D, Oliguria; 38.2°C | 1.4, 0.7, 0.3 | 2 | 3.2; | |
| Kim; Korea [43] | #1 | 36; M | 4; Living | None | Fever, Cough, Rhinorrhea, D, Oliguria, Chest discomfort; 38.5°C | 6.6, 5.4, 0.6 | 46 | 1.47 | 2 |
| #2 | 46; M | 9; deceased | DM | Cough; N/A | 4, 2, 1.3 | 27 | 2 | 1.85 | |
| Fernández-Ruiz; Spain [44] | #1 | 78; M | 8.3; N/A | HTN, Prostate CA | Fever, SOB | ||||
| #2 | 73; M | 1.8; N/A | HTN, DM | Fever, SOB, Cough, | |||||
| #3 | 80; M | 3.8; N/A | HTN, DM | SOB, Cough, Myalgia, Hyporexia | |||||
| #4 | 71; F | 6; N/A | HTN | Fever, SOB, Cough, Sore throat | |||||
| #5 | 71; M | 30; N/A | HTN, DM, CAD | Fever, Abd.P | |||||
| #6 | 76; M | 14.8; N/A | HTN, Obesity | Fever, Rhinorrhea | |||||
| #7 | 39; M | 16.8; N/A | HTN | Fever, Myalgia | |||||
| #8 | 65: M | 6.5; N/A | HTN, DM, OSA | Fever, SOB, Cough | |||||
| Nair; USA [45] | #1 | 51; M | 0.42; deceased | HTN, DM, CAD | Fever, Chills, Cough | 9.2, N/A, 1.1 | 0.88 | ||
| #2 | 37; M | 7; living | HTN, DM | Cough, Chills, Nasal congestion, Myalgia | 5, N/A, 2.4 | 180 | 1.93 | ||
| #3 | 63; F | 11.6; living | HTN | Fever, Chills, Cough, Myalgia, Headache; | 9, N/A, 1.2 | 34 | 1.2 | ||
| #4 | 30; F | 3.7; living | HTN, DM | Fever, Myalgia, Headache, V | 3.7, N/A, 1.2 | 1.5 | |||
| #5 | 56; M | 20; deceased | HTN, DM | Fever, Cough, Fatigue | 4, N/A, 0.3 | 306 | 4.8; AKI | ||
| #6 | 80; M | 13.8; living | HTN, DM, CAD | Fever, Chills, Fatigue, Myalgia, D | 5, N/A, 0.2 | 87 | 1.9 | ||
| #7 | 45; M | 3.4; deceased | HTN, DM | Fever, Cough, Myalgia, D | 5.2, N/A, 1.1 | 38 | 1.74 | ||
| #8 | 68; M | 11.6; N/A | HTN, DM | Fever, Cough, SOB | 6.7, N/A, 0.5 | 240 | 1.46; AKI | ||
| #9 | 75; F | 8.6; living | HTN, CA | Fever, Cough, SOB, Fatigue | 6.3, N/A, 0.4 | 50 | 1.3 | ||
| #10 | 57; F | 11.6; deceased | HTN, DM | Cough, SOB, Chills, Fatigue | 11, N/N, 1.4 | 230 | 1.6; AKI | ||
| Zhu; China [46] | #1 | 24; M | None | Fever; 38°C | N/A | 30 | 2.24 | ||
| #2 | 55; M | CAD | Cough, SOB, Fatigu | N/A, N/A, 0.3 | 80 | 3.48 | |||
| #3 | 29; M | None | Fever, Cough, SOB, Fatigue, D; 38.8°C | N/A, N/A, 0.47 | 118 | 2.84 | |||
| #4 | 30; M | HTN | Fever, Cough, SOB, Fatigue; 39°C | N/A, N/A, 0.6 | 42 | 2.36 | |||
| #5 | 50; M | HTN | Fever, Cough, SOB, Fatigue; 38.6°C | N/A, N/A, 0.4 | 40 | N | |||
| #6 | 65; F | None | Fever, Cough, SOB, Fatigue, D; 38°C | N/A, N/A, 0.7 | 40 | N | |||
| #7 | 52; M | HTN, CAD | Fever, Cough, SOB, Fatigue; 38.9°C | N/A, N/A, 1 | 54 | N | |||
| #8 | 49; M | None | Fever, Cough, SOB, Fatigue, D; 39.2°C | N/A | 49 | N | |||
| #9 | 59; M | HTN, COPD | Fever, Cough, SOB, Fatigue; 38.4°C | N/A, N/A, 0.4 | 100 | 5.2; AKI | |||
| #10 | 37; F | HTN | Fever, Cough, SOB, Fatigue; 40°C | N/A, N/A, 0.2 | 34 | 2.14 | |||
| Study; Country | Initial D-dimer, (μg/L) | Initial ALT/AST (U/L) | Initial LDH (U/L) | Baseline ISMs | Management | ICU & MV | Outcomes* | ||
| Banerjee; UK [12] | N/A | N/A | N/A | Aza, Pred | No change in ISMs | None | Recovered, N/A | ||
| 2032 | N/A | 1226 | Tac, MMF, Pred | Tac, MMF stopped, Abx | Both | Died after 12d | |||
| N/A | N/A | N/A | Tac, MMF, Pred | Tac, MMF stopped, Abx, oseltamivir | MV | Alive but suffers, 7d | |||
| N/A | N/A | N/A | Tac, MMF, Pred | MMF stopped | Both | Alive but suffers | |||
| N/A | N/A | N/A | Tac, MMF, Pred | MMF stopped, Abx, PC, furosemide, Blood transfusion | ICU | Alive but suffers, 7d | |||
| N/A | N/A | N/A | Tac, MMF | MMF stopped, PC | None | Alive but suffers, 11d | |||
| 1907 | N/A | 502 | Tac, Aza, Pred | Aza stopped, Tac reduced, Pred increased, HD | None | Recovered, 13d | |||
| Bartiromo; Italy [3] | N/A | N/A | N/A | Tac, Pred | Tac stopped, hydroxychloroquine, Abx, lopinavir/ritonavir (for 2 days), darunavir/cobicistat | None | Recovered, 14d | ||
| Chen; China [24] | N/A | 57/50 | N/A | Tac, MMF, Pred | ISMs stopped, Ribavirin, Abx, IVIG, IVMP | ICU | Recovered, 32d | ||
| Gandolfini; Italy [25] | N/A | 25/45 | 301 | Tac, MMF, Pred | Tac, MMF, stopped, Hydroxychloroquine, Abx, Lopinavir/ritonavir | None | Died, 5d | ||
| 832 | 26/62 | 718 | Tac, MMF, Pred | Tac, MMF, stopped, Abx, Hydroxychloroquine, Darunavir/cobicistat | None | Recovered, 8d | |||
| Guillen; Spain [26] | 8900 | N/A | N/A | Tac, Pred, Eve | Tac, Eve stopped, Abx, hydroxychloroquine, Lopinavir/Ritonavir, INF-β | Both | Alive but suffers, 12d | ||
| Huang; China [27] | N/A | N/A | N/A | MMF, Pred | MMF, Pred stopped, Abx, oseltamivir, Lopinavir/ritonavir, IVMP | MV | Died, 40d | ||
| Ning; China [28] | N/A | 20/23 but elevated later | N/A | MMF, Pred, CsA | No change in ISMs, Abx, lopinavir/ritonavir, IVIG | None | Recovered, 12d | ||
| Seminari; Italy [29] | N/A | 14/22 | 167 then 277 | Tac, MMF | No change in ISMs, Abx | None | Recovered, 13d | ||
| Wang; China [30] | N/A | N/A | N/A | MMF, Pred, CsA | No change in ISMs, INF-α, ribavirin, lopinavir/ritonavir IVMP | None | Recovered, 12d | ||
| Zhang; China [31] | 185 | 66/41 | 193 | Tac, MMF, Pred | MMF stopped, Tac reduced, oseltamivir | None | Recovered, 16d | ||
| 630 | 21/31 | 180 | MMF, Pred | ISMs stopped, Abx, oseltamivir | None | Alive but suffers, 7d | |||
| 1015 | 70/49 | 160 | Tac, MMF, Pred | Tac, MMF stopped, oseltamivir, IVIG | None | Recovered, 11d | |||
| 225 | 7/26 | 235 | Tac, MMF, Pred | ISMs stopped, oseltamivir | None | Recovered, 19d | |||
| 195 | 20/21 | 248 | Tac, MMF, Pred | No change in ISMs, oseltamivir | None | Recovered, 7d | |||
| Zhu; China [32] | N/A | 30/29 but elevated later | N/A | Tac, MMF, Pred | ISMs stopped, Abx, IVMP, IVIG, INF-α, GAD | None | Recovered, 18d | ||
| Arpali; Turkey [37] | Tac, Pred | No change in ISMs, oseltamivir | None | Recovered, 7d | |||||
| Billa; USA [38] | 1100 | 285 | Tac, MMF, Pred | Tac reduced, IVMP, | MV | Alive but suffers, 31d | |||
| Fontana; Italy [39] | N | N | Pred, CsA | CsA stopped, Pred increased, Abx, Hydroxycloroquine, Tocilizumab, IVIG, | None | Recovered, 22d | |||
| Hsu; USA [40] | 1124 | 54/44 | 361 | Tac, MMF, Pred | MMF stopped, hydroxychloroquine, remdesivir | ICU | Recovered, 15d | ||
| Kates, USA [41] | 34/48 | Tac, MMF, | MMF stopped, Tac reduced, Pred, Abx, chloroquine, hydroxychloroquine, | None | Recovered, 16d | ||||
| Johnson; USA [42] | Tac, MMF, | Tac, MMF reduced, Abx, hydroxychloroquine, | None | Recovered, 23d | |||||
| Kim; Korea [43] | 35/32 | Tac, MMF, Pred | Tac, MMF stopped, lopinavir/ritonavir, IVMP, hydroxychloroquine | None | Recovered, 23d | ||||
| 10/14 | Tac, MMF, Pred | MMF stopped, hydroxychloroquine, Abx, | None | Recovered, 17d | |||||
| Fernández-Ruiz; Spain [44] | Tac, Pred | Tac reduced, lopinavir/ritonavir | None | Died, 5d | |||||
| Tac, MMF, Pred | Tac reduced, MMF, Pred stopped, lopinavir/ritonavir, hydroxychloroquine, IVIG | None | Alive but suffers, 23d | ||||||
| Tac, MMF, Pred | Tac reduced, MMF stopped, lopinavir/ritonavir, hydroxychloroquine | None | Alive but suffers, 28d | ||||||
| Tac, MMF, Pred | Tac reduced, MMF, Pred stopped, lopinavir/ritonavir, hydroxychloroquine, IVIG, IVMP | None | Died, 16d | ||||||
| Tac | Tac reduced, hydroxychloroquine, IVIG, | None | Alive but suffers, 9d | ||||||
| MMF, Pred, Srl | MMF stopped, hydroxychloroquine, IVMP | None | Recovered, 13d | ||||||
| Tac, Pred, Eve | Tac, Eve stopped, hydroxychloroquine, IVMP, Tocilizumab, | None | Alive but suffers, 16d | ||||||
| Tac, MMF, Pred | Tac, MMF reduced, lopinavir/ritonavir, hydroxychloroquine | None | Alive but suffers, 17d | ||||||
| Nair; USA [45] | Tac, MMF, Pred, Eve | No change in ISMs | None | Recovered | |||||
| Tac, MMF, Pred | MMF stopped, hydroxychloroquine, azithromycin | None | Recovered | ||||||
| Tac, MMF | MMF stopped, hydroxychloroquine, azithromycin, Abx | None | Recovered | ||||||
| Tac, MMF, Pred | MMF stopped, hydroxychloroquine, azithromycin, Abx | None | Recovered | ||||||
| Tac, MMF, Pred | Tac, MMF stopped, hydroxychloroquine, azithromycin, Abx | Both | Died | ||||||
| Tac, MMF | Tac, MMF stopped, hydroxychloroquine, azithromycin, Abx, IVMP | Both | Recovered | ||||||
| Tac, MMF, Pred | MMF stopped, hydroxychloroquine, azithromycin, Abx, IVMP | None | Recovered | ||||||
| Tac, MMF, Pred | MMF stopped, hydroxychloroquine, azithromycin, Abx | ICU | Recovered | ||||||
| Pred, Srl | Srl stopped, hydroxychloroquine, azithromycin | Both | Died | ||||||
| Tac, MMF | MMF stopped, hydroxychloroquine, azithromycin, Abx, Pred | Both | Died | ||||||
| Zhu; China [46] | N | Tac, MMF, Pred | No change in ISMs, Avx | None | Recovered, 43d | ||||
| N | Tac, MMF, Pred | MMF stopped, Tac reduced, IVIG, Avx | MV | Recovered, 48d | |||||
| N | Tac, MMF, Pred | MMF stopped, IVMP, Avx | None | Recovered, 37d | |||||
| N | Tac, MMF, Pred | Tac, MMF stopped, IVIG, IVMP, Avx | None | Recovered, 37d | |||||
| 104; N/A | Tac, MMF, Pred | Tac, MMF stopped, IVIG, IVMP, Avx | None | Recovered, 34d | |||||
| N | Tac, MMF | Tac, MMF stopped, IVIG, IVMP, Avx | MV | Alive but suffers, 49d | |||||
| 94; N/N | Tac, MMF, Pred | Tac, MMF stopped, IVIG, IVMP, Avx | None | Recovered, 20d | |||||
| 97; N/A | Tac, MMF | Tac, MMF stopped, IVMP, Avx | None | Recovered, 34d | |||||
| 61; N/A | CsA, mizoribine | ISMs stopped, IVIG, IVMP, Avx | MV | Died, 6d | |||||
| 163; N/A | Tac, MMF, Pred | Tac, MMF stopped, IVIG, IVMP, Avx | None | Recovered, 31d | |||||
*
Recovered indicates recovery of clinical symptoms and signs not negative COVID-19 testing;
^
Initial Creatinine (Cr) indicates Cr serum level in mg/dL unit before encountering COVID-19.
ISMs – immunosuppressant medications; Max Temp – maximum temperature; DOI – duration of illness:; ICU – Intensive Care Unit; MV – mechanical ventilation; CRP – C-reactive protein; WBCC – white blood cell count; normal is 3.5–10 (×109/L); NC – neutrophil count, normal is 1.5–8 (×109/L); LC – lymphocyte count, normal is 1–3.5 (×109/L); AKI – acute kidney injury; Aza – azathioprine; MMF – mycophenolate mofetil; Tac – tacrolimus; Pred – prednisone; N/A – not available; DCD – donor after cardiac death; DBD – donor after brain death; Abx – antibiotics; Avx – antivirals; V/D – vomiting/diarrhea; PC – Paracetamol; SLS – Senior-Loken syndrome; LOS – loss of appetite; IVMP – intravenous methylprednisolone; IVIG – intravenous immunoglobin; D – Diarrhea; PTLD – post-transplant lymphoproliferative disease; SP – splenectomy; V – vomiting; Eve – everolimus:; INF-β – interferon beta; CsA – ciclosporin; N/V – nausea/vomiting; INF-α – interferon α; Abd.P – abdominal pain; GAD – glycyrrhizic acid diamine; CMV – cytomegalovirus; HHA – hereditary haemolytic anaemia; HD – hemodialysis; LDH – lactate dehydrogenase; ALT – alanine aminotransferase; AST – aspartate aminotransferase; LLS – lupus-like syndrome; NMZL – nodal marginal zone lymphoma; PD – Parkinson disease; NB – neurogenic bladder; DCM – dilated cardiomyopathy; CAD – coronary artery disease; OSA – obstructive sleep apnea; CA – cancer; Srl – Sirolimus.