Predictors of severe COVID-19 in kidney transplant recipients in the different epidemic waves: Analysis of the Spanish Registry
Por:
Villanego, F, Mazuecos, A, Perez-Flores, IM, Moreso, F, Andres, A, Jimenez-Martin, C, Molina, M, Canal, C, Sanchez-Camara, LA, Zarraga, S, Ruiz-Fuentes, MD, Aladren, MJ, Melilli, E, Lopez, V, Sanchez-Alvarez, E, Crespo, M, Pascual, J
Publicada:
1 jul 2021
Ahead of Print:
1 abr 2021
Resumen:
SARS-CoV-2 infection has produced high mortality in kidney transplant (KT) recipients, especially in the elderly. Until December 2020, 1011 KT with COVID-19 have been prospectively included in the Spanish Registry and followed until recovery or death. In multivariable analysis, age, pneumonia, and KT performed <= 6 months before COVID-19 were predictors of death, whereas gastrointestinal symptoms were protective. Survival analysis showed significant increasing mortality risk in four subgroups according to recipient age and time after KT (age 6 months, age <65 and time <= 6, age >= 65 and time >6 and age >= 65 and time <= 6): mortality rates were, respectively, 11.3%, 24.5%, 35.4%, and 54.5% (p < .001). Patients were significantly younger, presented less pneumonia, and received less frequently specific anti-COVID-19 treatment in the second wave (July-December) than in the first one (March-June). Overall mortality was lower in the second wave (15.1 vs. 27.4%, p < .001) but similar in critical patients (66.7% vs. 58.1%, p = .29). The interaction between age and time post-KT should be considered when selecting recipients for transplantation in the COVID-19 pandemic. Advanced age and a recent KT should foster strict protective measures, including vaccination.
Filiaciones:
Villanego, F:
Hosp Univ Puerta Mar, Dept Nephrol, Cadiz, Spain
Mazuecos, A:
Hosp Univ Puerta Mar, Dept Nephrol, Cadiz, Spain
Perez-Flores, IM:
Hosp Clinico San Carlos, Dept Nephrol, Madrid, Spain
Moreso, F:
Hosp Valle De Hebron, Dept Nephrol, Barcelona, Spain
Andres, A:
Hosp Univ Doce Octubre, Dept Nephrol, Madrid, Spain
Jimenez-Martin, C:
Hosp Univ La Paz, Dept Nephrol, Madrid, Spain
Molina, M:
Hosp Badalona Germans Trias & Pujol, Dept Nephrol, Barcelona, Spain
Canal, C:
Fdn Puigvert, Dept Nephrol, Barcelona, Spain
Sanchez-Camara, LA:
Hosp Univ Gregorio Maranon, Dept Nephrol, Madrid, Spain
Zarraga, S:
Hosp Univ Cruces, Dept Nephrol, Bilbao, Spain
Ruiz-Fuentes, MD:
Hosp Virgen Nieves, Dept Nephrol, Granada, Spain
Aladren, MJ:
Hosp Univ Miguel Servet, Dept Nephrol, Zaragoza, Spain
Melilli, E:
Hosp Univ Bellvitge, Dept Nephrol, Barcelona, Spain
Lopez, V:
Univ Malaga, Hosp Reg Univ Malaga, Dept Nephrol, IBIMA,REDinREN, Malaga, Spain
Sanchez-Alvarez, E:
Hosp Univ Cabuenes, Dept Nephrol, Gijon, Spain
Crespo, M:
Hosp del Mar, Inst Mar Med Res, Dept Nephrol, REDinREN, Barcelona, Spain
Pascual, J:
Hosp del Mar, Inst Mar Med Res, Dept Nephrol, REDinREN, Barcelona, Spain
Green Published, Bronze
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