Is COVID-19 infection more severe in kidney transplant recipients?
Graft Rejection
Male
[SDV]Life Sciences [q-bio]
MESH: Registries*
Aucun
MESH: Comorbidity
Comorbidity
MESH: Risk Factors
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
cardiovascular disease
Risk Factors
clinical research / practice
Immunology and Allergy
Pharmacology (medical)
MESH: Incidence
kidney transplantation / nephrology
Registries
MESH: Aged
MESH: France / epidemiology
MESH: Middle Aged
MESH: Transplant Recipients / statistics & numerical data*
Incidence
Middle Aged
3. Good health
Intensive Care Units
MESH: COVID-19 / epidemiology
[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Female
France
glomerular filtration rate (GFR)
kidney failure / injury
Immunosuppressive Agents
infection and infectious agents - viral
infectious disease
610
MESH: Graft Rejection / prevention & control
MESH: Severity of Illness Index
MESH: COVID-19 / diagnosis*
Humans
MESH: SARS-CoV-2
Propensity Score
Pandemics
Aged
Retrospective Studies
Immunosuppression Therapy
Transplantation
MESH: Humans
SARS-CoV-2
MESH: Graft Rejection / epidemiology*
COVID-19
MESH: Retrospective Studies
Kidney Transplantation
MESH: Male
immunosuppressive regimens
MESH: Immunosuppressive Agents / therapeutic use
MESH: Pandemics*
MESH: Propensity Score*
MESH: Immunosuppression / methods
MESH: Intensive Care Units
MESH: Kidney Transplantation*
MESH: Female
DOI:
10.1111/ajt.16424
Publication Date:
2020-12-01T23:44:38Z
AUTHORS (37)
ABSTRACT
There are no studies which have compared the risk of severe COVID-19 and related mortality between transplant recipients and nontransplant patients. We enrolled two groups of patients hospitalized for COVID-19, that is, kidney transplant recipients (KTR) from the French Registry of Solid Organ Transplant (n = 306) and a single-center cohort of nontransplant patients (n = 795). An analysis was performed among subgroups matched for age and risk factors for severe COVID-19 or mortality. Severe COVID-19 was defined as admission (or transfer) to an intensive care unit, need for mechanical ventilation, or death. Transplant recipients were younger and had more comorbidities compared to nontransplant patients. They presented with higher creatinine levels and developed more episodes of acute kidney injury. After matching, the 30-day cumulative incidence of severe COVID-19 did not differ between KTR and nontransplant patients; however, 30-day COVID-19-related mortality was significantly higher in KTR (17.9% vs 11.4%, respectively, p = .038). Age >60 years, cardiovascular disease, dyspnea, fever, lymphopenia, and C-reactive protein (CRP) were associated with severe COVID-19 in univariate analysis, whereas transplant status and serum creatinine levels were not. Age >60 years, hypertension, cardiovascular disease, diabetes, CRP >60 mg/L, lymphopenia, kidney transplant status (HR = 1.55), and creatinine level >115 µmol/L (HR = 2.32) were associated with COVID-19-related mortality in univariate analysis. In multivariable analysis, cardiovascular disease, dyspnea, and fever were associated with severe disease, whereas age >60 years, cardiovascular disease, dyspnea, fever, and creatinine level>115 µmol/L retained their independent associations with mortality. KTR had a higher COVID-19-related mortality compared to nontransplant hospitalized patients.
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CITATIONS (214)
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