Introduction and aim: COVID-19 is an ongoing pandemic that has altered our lives especially that of kidney transplant recipients (KTR). We aimed to compare the of COVID-19 positive KTR with non-transplant positive cases that were managed in the intensive care unit (ICU) during the pandemic.
Methods: Out of 2000 KTR that were followed up in Hamed Al-Essa Organ transplant center in Kuwait, we collected data of all COVID-19-positive KTR (group 1, n=79) till the end of January 2021. Clinical features, management details, and both patient and renal outcomes were reported and compared with (group 2, n=445) non-transplant cases admitted during the same period in the ICU during the pandemic. 
Results: Most of cases were males (74% vs.73%), aged 51.7±16 and 60.8± 14 years, respectively. Both groups were comparable regarding patients with diabetes mellitus (50.6 vs. 55.2%), hypertension (62% vs 57.1%), ischemic heart disease (20% vs 19.8%) and chronic kidney disease (1.3% vs 1.6%). Fever, cough, body aches and gastrointestinal symptoms were the most frequent presentation among KTR. Meanwhile, complicated cases with sepsis, volume depletion, shock, and ARDS predominated among the non-transplant group (p<0.05). Therapeutic management included anticoagulation (81 %) in both groups, while steroid and tocilizumab were used frequently among non-transplant group (8.7%).
Within 30 days follow up, in group 2 we found that acute kidney injury, respiratory failure requiring mechanical ventilation, and mortality rate were significantly higher.
Conclusion: We reported better outcome of ICU admitted COVID-19 positive KTR in comparison with the non-transplant patients possibly due to younger age modified immunosuppression.