학술논문
Temporal Reduction in COVID-19-Associated Fatality Among Kidney Transplant Recipients: The Brazilian COVID-19 Registry Cohort Study.
Document Type
Article
Author
de Sandes-Freitas, Tainá Veras; Pontello Cristelli, Marina; Requião-Moura, Lucio Roberto; Modelli de Andrade, Luís Gustavo; Almeida Viana, Laila; Duro Garcia, Valter; Costa de Oliveira, Claudia Maria; de Matos Esmeraldo, Ronaldo; Roberta de Lima, Paula; Maximina Fernandes Charpiot, Ida Maria; Alves Ferreira, Teresa Cristina; Fontanive Franco, Rodrigo; Alves Henrique Costa, Kellen Micheline; Rodrigues Simão, Denise; Fernandes Ferreira, Gustavo; Bandeira de Mello Santana, Viviane Brandão; Monteiro de Barros Almeida, Ricardo Augusto; Monica Deboni, Luciane; da Rocha Saldanha, Anita Leme; de Lourdes Noronha, Irene
Source
Subject
*KIDNEY transplantation
*COVID-19
*COHORT analysis
*SYMPTOMS
*DEATH rate
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Language
ISSN
0934-0874
Abstract
Data from the general population suggest that fatality rates declined during the course of the pandemic. This analysis, using data extracted from the Brazilian Kidney Transplant COVID-19 Registry, seeks to determine fatality rates over time since the index case on March 3rd, 2020. Data from hospitalized patients with RT-PCR positive SARS-CoV-2 infection from March to August 2020 (35 sites, 878 patients) were compared using trend tests according to quartiles (Q1: <72 days; Q2: 72-104 days; Q3: 105-140 days; Q4: >140 days after the index case). The 28-day fatality decreased from29.5%(Q1) to 18.8%(Q4) (pfor-trend = 0.004). In multivariable analysis, patients diagnosed in Q4 showed a 35% reduced risk of death. The trend of reducing fatality was associated with a lower number of comorbidities (20.7-10.6%, pfor-trend = 0.002), younger age (55-53 years, pfor-trend = 0.062), and better baseline renal function (43.6-47.7 ml/min/1.73m2, pfor-trend = 0.060), and were confirmed by multivariable analysis. The proportion of patients presenting dyspnea (pfor-trend = 0.001) and hypoxemia (pfor-trend < 0.001) at diagnosis, and requiring intensive care was also found reduced (pfor-trend = 0.038). Despite possible confounding variables and time-dependent sampling differences, we conclude that COVID-19-associated fatality decreased over time. Differences in demographics, clinical presentation, and treatment options might be involved. [ABSTRACT FROM AUTHOR]