Introduction: Outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in kidney transplant recipients (KTR) compared with matched cohort is certainly lacking for different pandemic waves and geographic regions.

Methods: In this single-center retrospective study of coronavirus disease (COVID-19) cases admitted from 26 March 2021 to 7 June 2021, a propensity-matched analysis in a 1:1 ratio was performed to compare the clinical profile and outcomes between KTR and non-KTR. A Cox proportional hazard model from the whole study population to analyze risk factors for severe disease and mortality was calculated.

Results: We identified 1052 COVID-19 cases of which 107(10.1%) were KTR. In propensity matched analysis, KTR had higher fever (81.6 % vs 60%; p-value = 0.01), lymphopenia (30% vs 11.7%; p-value = 0.02), higher neutrophil lymphocyte ratio (NLR) (43.3 % vs 25%; p-value = 0.05) and acute kidney injury (AKI) (66.6% vs 36.7%; p-value = 0.001). In Kaplan Meier survival analysis, there was no difference in mortality or severity of COVID-19. In cox hazard proportional analysis European cooperative oncology group score (ECOG) score of 1 to 2(HR (95% Lower CI, Upper CI) = 4.9(1.8-13.5); p-value <0.01], ECOG of > 2[ HR = 20(7.5,54.7); p-value < 0.01] and waitlisted status [HR = 1.9(1.1-3.3); p-value = 0.02] was associated with significant mortality. Kidney transplantation [HR = 0.8(0.47-1.44; p-value = 0.5] was not associated with mortality in the analysis

Conclusions: In our report kidney transplantation status had a different spectrum but was not found independently associated with COVID-19 severity or mortality.