Table 1.
Characteristics of kidney transplant recipients and patients on dialysis with COVID-19, overall and according to ACEi/ARB use status (nonusers/users)
| Characteristics | Recipients of Kidney Transplant | Patients on Dialysis | ||||
|---|---|---|---|---|---|---|
| All (n=459) | ACEi/ARB Use Status | All (n=1052) | ACEi/ARB Use Status | |||
| Nonusers (n=270) | Users (n=189) | Nonusers (n=764) | Users (n=288) | |||
| Patient characteristics | ||||||
| Male sex, n (%) | 276 (60) | 154 (57) | 122 (65) | 641 (61) | 440 (58) | 201 (70) |
| Age (yr), mean±SD | 59±13 | 60±14 | 58±12 | 66±15 | 67±14 | 63±16 |
| BMI (kg/m2), mean±SD | 27±5 | 27±5 | 27±5 | 27±5 | 27±6 | 27±5 |
| Race, n (%) | ||||||
| Asian | 12 (3) | 4 (2) | 8 (4) | 35 (3) | 18 (2) | 17 (6) |
| Black | 33 (7) | 24 (9) | 9 (5) | 55 (5) | 28 (4) | 27 (9) |
| White | 395 (85) | 228 (84) | 167 (88) | 903 (86) | 674 (88) | 229 (80) |
| Other or unknown | 19 (4) | 14 (5) | 5 (3) | 59 (6) | 44 (6) | 15 (5) |
| Tobacco use, n (%) | ||||||
| Current | 20 (4) | 16 (6) | 4 (2) | 80 (7) | 48 (6) | 32 (11) |
| Prior | 110 (24) | 67 (25) | 43 (23) | 237 (23) | 169 (22) | 68 (24) |
| Never | 236 (51) | 137 (51) | 99 (52) | 490 (47) | 358 (47) | 490 (46) |
| Unknown | 93 (20) | 50 (19) | 43 (23) | 245 (23) | 189 (25) | 56 (19) |
| Clinical frailty scale (AU), mean±SD | 3.0±1.6 | 3.2±1.7 | 2.8±1.5 | 4.0±1.8 | 4.1±1.8 | 3.7±1.8 |
| Patient identification, n (%)a | ||||||
| Symptoms only | 301 (88) | 171 (88) | 130 (88) | 559 (65) | 391 (62) | 168 (70) |
| Symptoms and contact | 28 (8) | 14 (7) | 14 (10) | 145 (17) | 111 (18) | 34 (14) |
| No symptoms but contact | 2 (1) | 1 (1) | 1 (1) | 76 (9) | 55 (9) | 21 (9) |
| Routine screening | 11 (3) | 9 (5) | 2 (1) | 85 (10) | 69 (11) | 16 (7) |
| COVID-19 test result (positive), n (%) | 425 (94) | 249 (95) | 176 (94) | 994 (97) | 723 (97) | 271 (95) |
| X-ray anormality (yes), n (%) | 219 (49) | 122 (46) | 97 (52) | 317 (31) | 226 (30) | 91 (33) |
| CT scan anormality (yes), n (%) | 145 (32) | 82 (31) | 63 (34) | 330 (32) | 246 (33) | 84 (30) |
| Asymptomatic, n (%)b | 9 (2) | 5 (2) | 4 (2) | 158 (15) | 115 (15) | 43 (15) |
| Comorbidities, n (%) | ||||||
| Obesity (BMI>30 kg/m2) c | 86 (22) | 47 (20) | 39 (24) | 202 (22) | 143 (22) | 59 (24) |
| Hypertension | 385 (84) | 206 (76) | 179 (95) | 883 (84) | 619 (81) | 264 (92) |
| Diabetes mellitus | 141 (31) | 88 (33) | 53 (28) | 448 (43) | 307 (40) | 141 (49) |
| Coronary artery disease | 91 (20) | 60 (22) | 31 (16) | 351 (33) | 251 (33) | 100 (35) |
| Heart failure | 39 (9) | 29 (11) | 10 (5) | 252 (24) | 177 (23) | 75 (26) |
| Chronic lung disease | 42 (9) | 31 (11) | 11 (6) | 145 (14) | 113 (15) | 32 (11) |
| Active malignancy | 27 (6) | 15 (6) | 12 (6) | 70 (7) | 53 (7) | 17 (6) |
| Autoimmune disease | 24 (5) | 15 (6) | 9 (5) | 50 (5) | 37 (5) | 13 (5) |
| Primary kidney disease, n (%) | ||||||
| Primary GN | 90 (20) | 56 (21) | 34 (18) | 159 (15) | 129 (17) | 30 (11) |
| Pyelonephritis | 18 (4) | 11 (4) | 7 (4) | 16 (2) | 14 (2) | 2 (1) |
| Interstitial nephritis | 21 (5) | 15 (6) | 6 (3) | 36 (3) | 28 (4) | 8 (3) |
| Hereditary kidney disease | 61 (14) | 31 (12) | 30 (16) | 80 (8) | 59 (8) | 21 (7) |
| Congenital diseases | 16 (4) | 7 (3) | 9 (5) | 16 (2) | 12 (2) | 4 (1) |
| Vascular diseases | 38 (8) | 21 (8) | 17 (9) | 141 (13) | 109 (14) | 32 (11) |
| Secondary glomerular disease | 22 (5) | 10 (4) | 12 (6) | 70 (7) | 53 (7) | 17 (6) |
| Diabetic kidney disease | 60 (13) | 41 (16) | 19 (10) | 260 (25) | 172 (23) | 88 (31) |
| Other | 54 (12) | 29 (11) | 25 (13) | 186 (18) | 125 (16) | 61 (21) |
| Unknown | 68 (15) | 41 (16) | 27 (15) | 84 (8) | 62 (8) | 22 (8) |
| Hemodialysis, n (%) | NA | NA | NA | 1000 (95) | 733 (96) | 267 (93) |
| Peritoneal dialysis, n (%) | NA | NA | NA | 52 (5) | 31 (4) | 21 (7) |
| Residual diuresis ≥200 ml/d, n (%) | NA | NA | NA | 343 (33) | 222 (30) | 121 (42) |
| Transplant waiting list status, n (%) | ||||||
| Active on waiting list | NA | NA | NA | 102 (10) | 69 (9) | 33 (11) |
| In preparation | NA | NA | NA | 102(10) | 64(8) | 38 (13) |
| Temporarily not on list | NA | NA | NA | 86 (8) | 54 (7) | 32 (11) |
| Not transplantable | NA | NA | NA | 593 (56) | 465 (61) | 128 (44) |
| Unknown | NA | NA | NA | 169 (16) | 112 (15) | 57 (20) |
| Time since transplantation, n (%) | ||||||
| <1 year | 29 (6) | 28 (11) | 1 (1) | NA | NA | NA |
| 1–5 years | 151 (33) | 99 (37) | 52 (28) | NA | NA | NA |
| >5 years | 276 (61) | 140 (52) | 136 (72) | NA | NA | NA |
| Medication use | ||||||
| Use of immunosuppressive medication, n (%) | ||||||
| Prednisone | 393 (86) | 239 (89) | 154 (81) | NA | NA | NA |
| Tacrolimus | 360 (78) | 215 (80) | 145 (77) | NA | NA | NA |
| Cyclosporine | 47 (10) | 26 (10) | 21 (11) | NA | NA | NA |
| Mycophenolate | 311 (68) | 183 (68) | 128 (68) | NA | NA | NA |
| Azathioprine | 19 (4) | 13 (5) | 6 (3) | NA | NA | NA |
| mTOR inhibitor | 64 (14) | 29 (11) | 35 (19) | NA | NA | NA |
| Disease-related characteristics | ||||||
| Presenting symptoms, n (%) | ||||||
| Sore throat | 61 (13) | 37 (14) | 24 (13) | 127 (12) | 84 (11) | 43 (15) |
| Cough | 295 (64) | 161 (60) | 134 (71) | 525 (50) | 379 (50) | 146 (51) |
| Shortness of breath | 194 (42) | 110 (41) | 84 (44) | 357 (34) | 270 (35) | 87 (30) |
| Fever | 334 (73) | 190 (71) | 144 (76) | 630 (60) | 454 (60) | 176 (61) |
| Headache | 74 (16) | 36 (13) | 38 (20) | 113 (11) | 71 (9) | 42 (15) |
| Nausea or vomiting | 74 (16) | 45 (17) | 29 (15) | 109 (10) | 72 (9) | 37 (13) |
| Diarrhea | 133 (29) | 78 (29) | 55 (29) | 130 (12) | 98 (13) | 32 (11) |
| Myalgia or arthralgia | 125 (27) | 71 (26) | 54 (29) | 210 (20) | 145 (19) | 65 (23) |
| Vital signs | ||||||
| Temperature (°C), mean±SD | 37.5±1.1 | 37.4±1.1 | 37.7±1.1 | 37.5±1.1 | 37.4±1.0 | 37.5±1.1 |
| Respiration rate (per min), mean±SD | 21±7 | 21±7 | 21±7 | 19±5 | 19±5 | 20±5 |
| Oxygen saturation in room air (%), mean±SD | 94±8 | 94±6 | 93±10 | 94±5 | 93±5 | 94±5 |
| Systolic BP (mm Hg), mean±SD | 132±21 | 132±22 | 132±19 | 137±26 | 135±25 | 143±28 |
| Diastolic BP (mm Hg), mean±SD | 77±15 | 77±16 | 77±13 | 75±15 | 74±15 | 78±16 |
| Pulse rate (BPM), mean±SD | 86±17 | 86±18 | 86±15 | 82±15 | 82±15 | 82±15 |
| Laboratory test results | ||||||
| Creatinine increase (>25%), n (%) | 136 (30) | 78 (29) | 58 (31) | — | — | — |
| eGFR (ml/min per 1.73m2), median (IQR) | 36 (21–53) | 36 (21–55) | 37 (23–49) | |||
| Lymphocytes (×1000/µl), median (IQR) | 0.8 (0.5–1.3) | 0.8 (0.5–1.3) | 0.8 (0.5–1.2) | 0.9 (0.6–1.3) | 0.9 (0.6–1.3) | 0.9 (0.6–1.3) |
| CRP (mg/L), median (IQR) | 44 (10–97) | 38 (8–96) | 49 (14–97) | 25 (6–75) | 25 (6–76) | 27 (6–72) |
Continuous variables are reported as mean±SD or median (IQR). Continuation/discontinuation groups were compared using t, Wilcoxon, or chi-squared test as appropriate. COVID-19, coronavirus disease 2019; ACEi/ARB, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker; BMI, body mass index; CT, computed tomography; NA, not applicable; mTOR, mammalian target of rapamycin; BPM, beats per minute; IQR, interquartile range; CRP, C-reactive protein.
a
342 patients had information on method of patient identification among transplant recipients, and 865 among dialysis patients.
b
COVID-19 test positive but without cough, sore throat, cough, shortness of breath, fever, headache, nausea/vomiting, diarrhea, myalgia/arthralgia.
c
392 patients had information on obesity among transplant recipients, and 915 among dialysis patients.