Introduction: The COVID-19 increased the mortality in organ solid transplant patients. This study described demographics, clinical, and laboratory findings in kidney transplant patients with COVID-19. We performed a comparative analysis between patients admitted in general hospitalization and intensive unit care (ICU), their graft survival, and patient survival rates.

Materials and methods: An observational analytic study by retrospective cohort was performed. We included adult kidney transplant patients with COVID-19 in Colombiana de Trasplantes from June 1st to July 31st of 2021. We performed a descriptive analysis with demographic and clinical characteristics. Patient and graft death-censored survival probabilities were calculated using the Kaplan-Meier method. Survival curves were compared for the patients admitted in general hospitalization and ICU.

Results: During the study period, we found 191 cases of COVID-19 in our kidney transplant recipients. We excluded 64 patients (33.5%) because patient data was not available for follow-up. Most of the patients were men (n = 72, 56.7%) with a mean age of 48.3 years. Only 14.2% of the patients were vaccinated at the time of diagnosis for COVID-19. The most frequently used immunosuppressive regimen was tacrolimus/mycophenolate in 98 patients (77.2%). The most common symptoms were respiratory symptoms (73.2%) and fever (53.5%), and 38 patients (29.9%) developed acute kidney injury. A total of 55 patients required hospital admission, among those, 18 (32.7%) were admitted in ICU.  A total of 7 patients (5.5%) lost kidney grafts. The probability of graft survival was 94.1% (IC 95%: 0.90-0.98) at 30 days of follow-up. A total of 15 (11.8%) patients died during the study period and the probability of patient survival was 88.2% (IC 95%: 0.82-0.94) at 30 days of follow-up. We found that patients with a severe disease admitted to ICU had a significant higher mortality rate compared to those admitted in general hospitalization.

Conclusion: In this cohort, the clinical presentation of COVID-19 infection was similar to that reported in the general population. We found that kidney transplant recipients infected with COVID-19 had a high mortality rate compared to general population. Mortality was higher in kidney transplant patients with a severe presentation. In the study period that we analyzed, patients did not have wide access to vaccination against COVID-19, which did not allow us to measure the effect of vaccination in mortality rates. The graft loss in this study was related to the usual causes of loss in kidney transplant patients.