Undoubtedly, kidney transplant recipients have a higher mortality due to COVID?19 disease compared to the general population

With interest, we read the article of Hugo et al, who described a mortality 8.7% in 46 solid organ transplant recipients after COVID-19 infection [1. Because misinterpretation may have detrimental implications for regarding vaccine prioritization, think it is important to comment on misleading title and limitations their conclusions due an obvious selection bias control group. In Berlin-Brandenburg region, serve area 6.1 million people approximately 2500 kidney recipients. Here, 209.960 cases (3.4% total population) 6002 deaths (2.9% registered cases) were documented up March 7 [2. During last year, observed 114/2500 (4.6%) 10/114 (8.8%) COVID-19. Hence, was strikingly similar our cohort compared al. [1 lower as previously cohorts with rates between 12% 32% (see Table 1). summary, at least three- fourfold higher than general population, supporting thorough analysis from United Kingdom four-time hazard ratio death [3. Age > 60 RR 20/min PCT LDH Dyspnea Cravedi [5 Multicentric, TANGO Registry (US, Spain, Italy) March–May 2020 Older age Pneumonia Sanchez-Alvarez [6 Spanish Society Nephrology - April ARDS admission Lung disease Fava [7 Spain March–April 482 SOTR 318 KTR 65 years Congestive heart failure Obesity Diabetes Kates [8 UW SOT COVID Akalin [9 Monocentric, Montefiore Medical Center, New York, States Male Sex Jager [10 ERA-EDTA Feb–April De Meester [11 Belgium Disease severity Allograft dysfunction CRP, IL-6, Chest XR abnormality ICU/MV Kute [12 India March–Sep view, meaningful comparator should represent which not case recently published paper [1, where group exhibited 17.5%, far exceeding overall Germany (70.800 2.445 Mio infected people; 2.9%) [2, suggesting strong controls. The selected LEOSS registry hospitalized cases, are treated large part tertiary university hospitals [4. This can lead mortality, since these referral centers severe complicated ICU cases. As consequence, had substantial rate critical (23.9% vs. 29.5% 4.4% vs 8.6%, respectively). Unfortunately, proportion patients requiring stay reported study. Another major risk factor namely age, appears highly unmatched, >65 almost twice high (47.5% 23.9%), additionally distorts conclusions. We acknowledge authors’ ambition gain insights about attributable immunosuppression transplantation independent comorbidities However, because does reflect effects decision-making process stratification immunization, all data clearly demonstrate much authors declare no funding. conflicts interest.