TABLE 1.
Patient demographics and clinical characteristics
| Total (N = 25) | Nonsevere (N = 15) | Severe (N = 10) | p value | |
|---|---|---|---|---|
| Demographics | ||||
| Age, median (IQR), years | 60.0 (54.0–64.5) | 60.0 (48.0–65.0) | 61.5 (54.8–64.2) | .77 |
| Gender, N (%) | ||||
| Male | 12 (48.0) | 4 (26.7) | 8 (80.0) | .01 |
| Female | 13 (52.0) | 11 (73.3) | 2 (20.0) | |
| Race, N (%) | ||||
| Black or African American | 13 (52.0) | 8 (53.3) | 5 (50.0) | .78 |
| White or Caucasian | 4 (16.0) | 3 (20.0) | 1 (10.0) | |
| American Indian or Alaskan | 1 (4.0) | 1 (6.7) | 0 | |
| Other | 7 (28.0) | 3 (20.0) | 4 (40.0) | |
| Ethnicity, N (%) | ||||
| Hispanic or Latino | 7 (28.0) | 3 (20.0) | 4 (40.0) | 0.38 |
| Non-Hispanic | 18 (72.0) | 12 (80.0) | 6 (60.0) | |
| Transplanted organ, N (%) | ||||
| Kidney | 23 (92.0) | 13 (86.7) | 10 (100.0) | .50 |
| Liver | 2 (8.0) | 2 (13.3) | 0 | |
| Transplantation to admission, days, median (IQR) | 1581 (566–2699) | 2298 (789–3359) | 1044 (473–2403) | .12 |
| Admission immunosuppression, N (%) | ||||
| Tacrolimus | 18 (72.0) | 9 (60.0) | 9 (90.0) | .18 |
| Belatacept | 7 (28.0) | 6 (40.0) | 1 (10.0) | .18 |
| Antimetabolite | 17 (68.0) | 9 (60.0) | 8 (80.0) | .40 |
| Prednisone | 22 (88.0) | 12 (80.0) | 10 (100.0) | .25 |
| Microbiology | ||||
| Initial N2 CT, median (IQR) | 22.9 (18.7–25.4) | 22.9 (16.3–29.4) | 23.1 (18.9–24.6) | .97 |
| Laboratory | ||||
| Tacrolimus (ng/ml), median (IQR) [N] | ||||
| Initial | 12.0 (6.5–25.0) [18] | 10.0 (4.0–26.0) [9] | 13.0 (7.0–24.0) [9] | .65 |
| Trough | 4.0 (3.0–6.3) [18] | 6.0 (4.0–8.5) [9] | 3.0 (3.0–4.0) [9] | .02 |
| Creatinine (mg/dl), median (IQR)b | ||||
| Initial | 2.0 (1.3–2.9) | 1.6 (1.0–2.9) | 2.2 (1.5–3.4) | .17 |
| Peak | 2.4 (1.8–5.0) | 1.9 (1.2–3.4) | 3.9 (2.2–5.7) | .03 |
| AST (U/L), median (IQR) | ||||
| Initial | 35.0 (29.5–51.0) | 34.0 (27.0–43.0) | 45.0 (32.2–60.0) | .09 |
| Peak | 57.0 (44.0–120.5) | 50.0 (37.0–58.0) | 109.0 (58.2–144.5) | <.01 |
| ALT (U/L), median (IQR) | ||||
| Initial | 25.0 (18.5–34.5) | 22.0 (12.0–29.0) | 34.0 (21.8–42.0) | .06 |
| Peak | 37.0 (25.5–119.0) | 32.0 (23.0–44.0) | 101.5 (36.2–158.8) | .02 |
| hsCRP (mg/L), median (IQR) | ||||
| Initial | 88.6 (50.8–191.6) | 76.1 (11.5–146.4) | 156.7 (88.2–225.8) | .02 |
| Peak | 154.4 (78.8–213.2) | 139.2 (52.9–202.1) | 184.4 (98.9–237.0) | .22 |
| Ferritin (ng/ml), median (IQR) | ||||
| Initial | 1,366.0 (571.0–2186.0) | 1,127.0 (227.0–1958.0) | 1,488.0 (921.3–4714.0) | .26 |
| Peak | 2,206.0 (1,184.0–3656.0) | 2,206.0 (719.0–3390.0) | 2,243.0 (1,226.0–8589.0) | .40 |
| D-dimer (mg/L), median (IQR) | ||||
| Initial | 1.0 (0.6–1.7) | 1.2 (0.6–2.2) | 0.8 (0.6–1.4) | .34 |
| Peak | 2.3 (1.5–13.3) | 1.6 (1.3–4.2) | 11.6 (2.3–21.6) | .02 |
| Peak IL-6 (pg/ml), median (IQR) | 44.5 (5.0–189.8) | 10.0 (5.0–107.5) | 159.5 (19.2–218.0) | .09 |
| COVID-19 therapies | ||||
| Atazanavir, N (%) | 6 (24.0) | 4 (26.7) | 2 (20.0) | >.99 |
| Convalescent plasma, N (%) | 3 (12.0) | 0 | 3 (30.0) | .05 |
| Hydroxychloroquine, N (%) | 24 (96.0) | 14 (93.3) | 10 (100.0) | >.99 |
| Methylprednisolone, N (%) | 7 (28.0) | 1 (6.7) | 6 (60.0) | .01 |
| Remdesivir, N (%) | 1 (4.0) | 0 | 1 (10.0) | .4 |
| Tocilizumab, N (%) | 17 (68.0) | 8 (53.3) | 9 (90.0) | .08 |
| Clinical | ||||
| Hospitalization days, median (IQR)a | 10.0 (5.8–21.0) | 7.0 (5.0–15.0) | 11.0 (10.0–27.0) | .09 |
| Modified WHO OSCI, first 24 h, N (%) | ||||
| Score <5 (initially nonsevere) | 20 (80.0) | 15 (100.0) | 5 (50.0) | .01 |
| Score ≥5 (initially severe) | 5 (20.0) | 0 | 5 (50.0) | |
| Critical care in ICU during hospitalization, N (%) | ||||
| Did not require critical care | 15 (60.0) | 15 (100.0) | 0 | <.01 |
| Required critical care | 10 (40.0) | 0 | 10 (100.0) | |
| Highest oxygen required, N (%) | ||||
| Room air – 6L nasal cannula | 15 (60.0) | 15 (100.0) | 0 | <.01 |
| NRB, HFNC, or intubation | 10 (40.0) | 0 | 10 (100.0) | |
| 28 days mortality, N (%) | 4 (16) | 0 | 4 (40.0) | .02 |
Note: Percentages are calculated per grouping (all, nonsevere, and severe). Non-severe and severe categorization represent the highest acuity COVID-19 severity during the entire hospital course as determined by the modified World Health Organization COVID-19 Ordinal Scale for Clinical Improvement (WHO OSCI). P values represent comparisons between nonsevere and severe groups. Individual p values were calculated for immunosuppressive agents and therapies as patients received multiple medications simultaneously.
Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; CT, cycle threshold; HFNC, high-flow nasal cannula; hsCRP, high-sensitivity C-reactive protein; IQR, interquartile range; N2, nucleocapsid 2 gene; NRB, nonrebreather.
Creatinine values for two patients in the non-severe group were censored due to dialysis.
Days of admission were censored for three patients who remained inpatient at the time of analysis.