A nationwide study of kidney transplant recipients and waitlisted candidates found COVID increased mortality in both groups in 2020 by 20% among recipients and 25% among in candidates compared with 2019.
Patients from racial and ethnic minorities were disproportionately affected. Black and Hispanic waitlisted patients together accounted for 50% of all non-COVID deaths last year but 72% of all COVID deaths. Among transplant recipients, these groups accounted for 39% of non-COVID deaths but 62% of COVID deaths.
The study by researchers at Columbia University is the first analysis of data from across the United States; previous studies have been restricted to data from small cohorts of patients, making it difficult to accurately assess the risk.
The excess risk of COVID-19 mortality particularly for patients on a transplant waitlist may alter the amount of benefit associated with transplantation, which could impact clinical decision-making. Most waitlisted patients receive kidney dialysis outside the home several days a week and may be more exposed to COVID than transplant recipients.
"Excess death related to COVID was observed among both waitlisted candidates and transplant recipients and these data should help centers understand the risks associated with transplantation during the COVID pandemic," says the study's senior author Sumit Mohan, MD, MPH, associate professor of medicine at Columbia University Vagelos College of Physicians and Surgeons and of epidemiology at Columbia University Mailman School of Public Health.
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The article, titled "COVID-19-Associated Mortality among Kidney Transplant Recipients and Candidates in the United States," was published online Sept. 29 in the Clinical Journal of the American Society of Nephrology. doi: 10.2215/CJN.02690221.
Other authors are Kristen L. King (Columbia), S. Ali Husain (Columbia), and Jesse Schold (Cleveland Clinic).
The research was supported by the U.S. National Institutes of Health (grants KL2 TR001874, U01 DK116066, R01 DK114893, and R01 MD014161); the U.S National Science Foundation (grant 2032726); and Health Resources and Services Administration contract 234-2005-370011C.
The authors reported no relevant financial disclosures.
