Table 4. Baseline risk factors, management, and outcomes vs. time from transplantation to COVID-19 diagnosis.
| All (n = 210) | ≤ 6 months from transplant to diagnosis (n = 18) | > 6 months from transplant to diagnosis (n = 192) | P-value | |
|---|---|---|---|---|
| Baseline risk factors (%) | ||||
| Age ≥ 70 years | 60 (28.6) | 4 (22.2) | 56 (29.2) | .53 |
| Diabetes mellitus | 70 (33.3) | 6 (33.3) | 64 (33.3) | 1.00 |
| Chronic cardiopathy | 54 (25.7) | 5 (27.8) | 49 (25.5) | 1.00 |
| Chronic kidney disease | 74 (35.2) | 5 (27.8) | 69 (35.9) | .49 |
| Dyspnea | 81 (38.6) | 8 (44.4) | 73 (38.0) | .59 |
| Respiratory rate > 20 bpm | 57 (31.1) | 7 (53.8) | 50 (29.4) | .13 |
| O2 sat < 95% | 61 (29.2) | 6 (33.3) | 55 (28.8) | .69 |
| Lymphocytes < 1 x 1000/μL | 142 (68.6) | 14 (77.8) | 128 (67.7) | .38 |
| Creatinine > 1.3 mg/dL | 133 (63.9) | 12 (66.7) | 121 (63.7) | .80 |
| Lactate dehydrogenase ≥ 300 U/L | 79 (40.9) | 8 (50.0) | 71 (40.1) | .44 |
| C-reactive protein ≥ 100 mg/L | 69 (33.5) | 7 (41.2) | 62 (32.8) | .48 |
| D-dimer ≥ 600 ng/mL | 91 (52.3) | 12 (85.7) | 79 (49.4) | .05 |
| Baseline immunosuppression (%) | ||||
| Mofetil mycophenolate | 145 (69.0) | 15 (83.3) | 130 (67.7) | .17 |
| Azathioprine | 5 (2.4) | 0 (0) | 5 (2.6) | 1.00 |
| Ciclosporin | 18 (8.6) | 1 (5.6) | 17 (8.9) | 1.00 |
| Tacrolimus | 156 (74.3) | 17 (94.4) | 139 (72.4) | .08 |
| Sirolimus/everolimus | 49 (23.3) | 2 (11.1) | 47 (24.5) | .32 |
| Prednisone | 146 (69.5) | 14 (77.8) | 132 (68.8) | .09 |
| Changes in immunosuppression (%)a | ||||
| Decrease or stop antimetabolite | 110/150 (73.3) | 8/15 (53.3) | 102/135 (75.6) | .12 |
| Decrease or stop calcineurin inhibitors | 119/170 (70.0) | 9/17 (52.9) | 110/153 (71.9) | .11 |
| Decrease or stop mTOR inhibitors | 35/49 (71.4) | 2/2 (100) | 33/47 (70.2) | .91 |
| Decrease or stop steroids | 13/146 (8.9) | 2/14 (14.3) | 11/132 (8.3) | .80 |
| Viral or host-targeted medications (%)b | ||||
| Hydroxychloroquine | 193/200 (96.5) | 15/16 (93.8) | 178/184 (96.7) | 1.00 |
| Lopinavir/ritonavir | 91/200 (45.5) | 6/16 (37.5) | 85/184 (46.2) | .50 |
| Darunavir/cobicistat | 7/200 (3.5) | 1/16 (6.3) | 6/184 (3.3) | 1.00 |
| Interferon | 6/200 (3.0) | 1/16 (6.3) | 5/184 (2.7) | .98 |
| Tocilizumab | 49/200 (24.5) | 6/16 (37.5) | 43/184 (23.4) | .34 |
| Azithromycin | 34/200 (17.0) | 0/16 (0) | 34/184 (18.5) | .11 |
| Methylprednisolone | 20/200 (10.0) | 1/16 (6.3) | 19/184 (10.3) | .86 |
| Highest level of respiratory support (%) | ||||
| High flow/non-invasive mechanical ventilation | 22 (10.5) | 3 (16.7) | 19 (9.9) | .62 |
| Intubation | 24 (11.4) | 5 (27.8) | 19 (9.9) | .06 |
| Complications during hospitalization (%) | ||||
| Acute respiratory distress syndrome | 54 (26.0) | 7 (41.2) | 47 (24.6) | .23 |
| Hospital-acquired coinfections | 24 (11.9) | 4 (25.0) | 20 (10.8) | .20 |
| Graft dysfunction | 12 (5.7) | 2 (11.1) | 10 (5.2) | .62 |
| Graft lost | 5 (2.4) | 1 (5.6) | 4 (2.1) | .91 |
| Final outcome (%) | ||||
| Intensive care unit admission | 37 (17.6) | 8 (44.4) | 29 (15.1) | .01 |
| Death | 45 (21.4) | 6 (33.3) | 39 (20.3) | .32 |
| Unfavorable* | 63 (30.0) | 10 (55.6) | 53 (27.6) | .01 |
aDenominator includes patients on the agent at baseline and known adjustment status.
bDenominator includes all patients under viral or host-targeted treatment.
*Clinical outcome is categorized into favorable (full recovery and discharged or stable clinical condition) and unfavorable (admission to ICU or death).