TABLE 4.
Comparing COVID‐19 severity, treatment and outcome of kidney transplant recipients with COVID‐19 in the two waves
| 1st wave (Overall) n = 157 | 2nd wave (Overall) n = 102 | p‐value | 1st wave (Survivors) n = 142 | 2nd wave (Survivors) n = 92 | p‐value | 1st wave (non‐survivors) n = 15 | 2nd wave (non‐survivors) n = 10 | p‐value | Mortality difference within waves (p‐value) | |
|---|---|---|---|---|---|---|---|---|---|---|
| Oxygen support | .0001 versus .0001 | |||||||||
| Ambient air | 78 (49.6) | 64 (62.7) | .23 | 78 (54.9) | 64 (69.6) | .02 | 0 (0) | 0 (0) | N/A | |
| Low‐flow oxygen | 48 (30.6) | 21 (20.6) | .08 | 48 (33.8) | 21 (22.8) | .07 | 0 (0) | 0 (0) | N/A | |
| NRBM/HFO | 10 (6.6) | 5 (4.9) | .78 | 10 (7) | 5 (5.4) | .78 | 0 (0) | 0 (0) | N/A | |
| Bi‐PAP | 6 (3.8) | 2 (1.9) | .48 | 6 (4.3) | 2 (2.2) | .48 | 0 (0) | 0 (0) | N/A | |
| Mechanical ventilation | 15 (9.4) | 10 (9.9) | 1 | 0 (0) | 0 (0) | N/A | 15 (100) | 10 (100) | 1 | |
| Immunosuppression changes | .0001 versus .0001 | |||||||||
| No change in maintenance drugs | 0 (0) | 25 (24.5) | .0001 | 0 (0) | 25 (27.1) | .0001 | 0 (0) | 0 (0) | N/A | |
| MMF/AZA tapered | 31 (20) | 35 (34.3) | .012 | 31 (22) | 35 (38) | .01 | 0 (0) | 0 (0) | N/A | |
| MMF/AZA stopped | 122 (80) | 42 (41.2) | .0001 | 108 (78) | 32 (34.7) | .0001 | 15 (100) | 10 (100) | 1 | |
| CNI stopped/tapered | 26 (19) | 18 (17.6) | .86 | 26 (21) | 8 (8.6) | .056 | 15 (100) | 10 (100) | 1 | |
| Steroids IV added | 79 (50.3) | 38 (37.2) | .04 | 64 (45) | 28 (30.4) | .02 | 15 (100) | 10 (100) | 1 | |
| Therapeutic regimen | ||||||||||
| IV Methyl prednisone | 70 (44.5) | 10 (9.8) | .0001 | 64 (45) | 21 (22.8) | .0005 | 6 (40) | 7 (70) | .22 | .78 versus .004 |
| IV Dexamethasone | 9 (5.7) | 28 (27.4) | .0001 | 6 (4.2) | 7 (7.6) | .38 | 3 (20) | 3 (30) | .65 | .04 versus .057 |
| I V Remdesivir | 74 (47) | 67 (65.6) | .03 | 63 (44) | 57 (56.5) | .01 | 11 (73) | 10 (100) | .12 | .056 versus .014 |
| I V Bevacizumab | 0 (0) | 2 (1.9) | .15 | 0 (0) | 0 (0) | N/A | 0 (0) | 2 (20) | .15 | N/A versus .008 |
| I V Itolizumab | 0 (0) | 2 (1.9) | .15 | 0 (0) | 0 (0) | N/A | 0 (0) | 2 (20) | .15 | N/A versus .008 |
| I V Tocilizumab | 11 (7) | 0 (0) | .004 | 5 (3.5) | 0 (0) | 0.15 | 6 (40) | 0 (0) | .05 | .0001 versus N/A |
| I V/SC UFH or LMWH | 79 (50.3) | 94 (92) | .0001 | 64 (45) | 84 (91.3) | .0001 | 15 (100) | 10 (100) | 1 | .0001 versus 1 |
| I V antibiotics | 32 (20.3) | 28 (27.4) | .22 | 22 (15.5) | 18 (19.5) | .47 | 10 (66.7) | 10 (100) | .06 | .0001 versus .0001 |
| I V/oral antifungal | 8 (5) | 21 (20.5) | .0002 | 5 (3.5) | 14 (15.2) | .002 | 3 (20) | 7 (70) | .03 | .02 versus .0005 |
| I V immunoglobulin | 35 (22) | 5 (4.9) | .0001 | 23 (16) | 3 (3.3) | .0023 | 12 (80) | 2 (20) | .005 | .0001 versus .07 |
| Azithromycin | 84 (53) | 68 (66.7) | .039 | 78 (55) | 69 (75) | .002 | 6 (40) | 7 (70) | .22 | .29 versus .71 |
| Ivermectin | 0 (0) | 18 (17.7) | .0001 | 0 (0) | 15 (16.3) | .0001 | 0 (0) | 3 (30) | .052 | N/A versus .37 |
| Nitazoxanide | 0 (0) | 14 (13.7) | .0001 | 0 (0) | 14 (15.2) | .0001 | 0 (0) | 0 (0) | N/A | N/A versus .34 |
| Favipiravir | 36 (22) | 12 (11.8) | .032 | 32 (22) | 10 (10.8) | .02 | 4 (27) | 2 (20) | 1 | .52 versus .33 |
| Tofacitinib | 0 (0) | 8 (7.9) | .0005 | 0 (0) | 5 (5.4) | .0001 | 0 (0) | 3 (30) | .052 | N/A versus .02 |
| Hydroxychloroquine | 18 (11) | 0 (0) | .0001 | 15 (10.5) | 0 (0) | .0006 | 3 (20) | 0 (0) | .25 | .38 versus N/A |
| Convalescent plasma | 21 (13) | 3 (2.9) | .004 | 18 (12) | 2 (2.2) | .003 | 3 (20) | 1 (10) | .62 | .41 versus .26 |
| Outcome | ||||||||||
| Allograft dysfunction | 79 (50) | 67 (65.6) | .015 | 64 (45) | 57 (56.5) | .015 | 15 (100) | 10 (100) | 1 | .001 versus .01 |
| HD requirement | 26 (16) | 8 (7.9) | .058 | 19 (13.4) | 5 (5.4) | .07 | 7 (47) | 3 (30) | .67 | .0014 versus .02 |
| Graft loss | 10 (6.3) | 5 (4.9) | .78 | 10 (7) | 3 (3.3) | .25 | 0 (0) | 2 (20) | .15 | N/A versus .07 |
| ARDS | 31 (20) | 17 (16.7) | .62 | 18 (12) | 7 (7.6) | .28 | 13 (87) | 10 (100) | .5 | .001 versus .0001 |
| ICU admissions | 31 (20) | 38 (37.2) | .002 | 16 (11) | 28 (30.4) | .0005 | 15 (100) | 10 (100) | 1 | .0001 versus .0001 |
| 28‐day mortality | 15 (9.6) | 10 (10) | 1 | 0 (0) | 0 (0) | N/A | 15 (100) | 10 (100) | 1 | N/A |
Note: Data expressed as median (interquartile range) or numbers and percentages. Bold indicates statistically significant value.
Abbreviations: ARDS, acute respiratory syndrome; AZA, azathioprine; Bi‐PAP: bi‐level positive pressure ventilation; CNI, calcineurin inhibitors; HFO, high‐flow oxygen; ICU, intensive care unit; LMWH, low‐molecular weight heparin; MMF, mycophenolate; NRBM, non‐rebreather mask; UFH: unfractionated heparin.