Introduction: During Covid-19 pandemics, renal transplant recipientes presented higher rates of hospitalization and mortality. In general population, there was significant diferences betwen male and female, on severity of disease and mortality.  The aim of this study was to compare the end points of Covid-19 in renal transplant recipiens, according to gender, in order to identify risk factors.
Patients and Methods:  Single center retrospective study. From March 2020 to December 2022, 402 renal transplant recipients with Covid-19 infection diagnosis were included and stratified by gender. Primary end point was Covid-19 mortality.
Results: Majority of included patients were male (n=247, 61%). Global mortality was of 20.1% (n=81), being 24% in male and   15% in female (p=0.035).  Male were older (54 vs 48 years old, p<0.001), with higher incidence of comorbidities such as systemic hypertension (87% vs 79%, p=0.027),  diabetes (45%  vs  32%,  p=0.012) and cardiovascular events (20% vs 5%, p<0.001) compared to female. Hospitalization rate was higher among male (49% vs 38%, p=0.039). However, there was no difference in intensive care need, respiratory support, lenght of hospitalization and changes in immunosupressive protocol among gender. Mortality was associated with male gender (OR=1.76), diabetes (OR=1.83), cardiovascular disease (OR=2.86), lung disease (OR=5.21), previous rejection episodes (OR=2.38), and older age (OR=1,06). Conclusion: Higher mortality was observed in male, being one in every four infected, similar to previous reports in general population in Covid-19 (2022) or MERS-Cov (2012) pandemics. This higher incidence of hospitalization and mortalify in male could be justified by the higher prevalence of comorbidities, such as diabetes and cardiovascular disease.