Abstract P027: COVID-19-Related Mortality And A Decline In U.S. Kidney Transplantation During The Second Year Pandemic

Abstract

Background: Since COVID-19 treatment and immunization have been implemented, effects of COVID-19pandemic on kidney transplantations (KT) may be altered from the prior year. We aim to examine the association of COVID-19 cases and deaths with the change in the number of KT in 2022. Method: A cross-sectional study examined data of COVID-19 cases and death, and adult KT in the United States, retrieved from the CDC and the OPTN/SRTR, respectively. The association of the cumulative COVID-19 cases and deaths between 1/21/2020 and 10/11/2021 among 52 states in the United States and the difference in the number of KT between the year 2020 and 2021 (ΔKT) was examined by multiple linear regression. Results: Of 44,377,493 COVID-19 cases, 713,950 had COVID-19-realted death during the study period. Of all 52 states, 38,947 and 31,273 KT were performed in 2020 and 2021, respectively (mean difference ±SEM 148±27, 95%CI 93, 202). Median (IQR) ΔKT 2020 - 2021 was 93 (26, 167). Compared to year 2020, every 10,000 increased COVID-19 cases and deaths were associated with a decrease in 2 and 102 KTs in year 2021, respectively (COVID-19 cases: β coeff 0.00018, 95%CI 0.00016, 0.00021; Figure 1A and COVID-19 deaths: β coeff 0.01020, 95%CI 0.00839, 0.01202; Figure 1B). After adjusted for categorized KT in 2020 (< or ≥ median KT in 2020 of 468), COVID-19 cases (< or ≥ median cases of 586,869) or COVID-19 deaths (< or ≥ median deaths of 16,635), and the interaction term between KT in 2020 and COVID-19 cases or deaths, the states with a higher COVID-19 cases (≥586,869 cases) had a decrease in 53 KT in 2021; whereas, there was a decrease in 212 KT among states with greater COVID-19 deaths (≥16,635 deaths; COVID-19 cases: β coeff 53, 95%CI -291, 397, p interaction 0.874 and COVID-19 deaths: β coeff 212, 95%CI 96, 329, p interaction NS). Conclusion: The decline of KT in 2021 compared to 2020 is positively associated with COVID-19-related deaths, but not COVID-19 cases. This association is not modified by the number of KTs in 2020 and COVID-19 deaths in different states.