학술논문
Clinical characteristics and outcomes in COVID-19 in kidney transplant recipients: a propensity score matched cohort study
Document Type
article
Author
Polianna Delfino-Pereira; Vanessa das Graças José Ventura; Magda Carvalho Pires; Daniela Ponce; Gabriel Assis Lopes do Carmo; Lilian Pires de Freitas do Carmo; Bruno Barbosa Miranda de Paiva; Alexandre Vargas Schwarzbold; Angélica Gomides dos Reis Gomes; Bruno Mateus de Castro; Carísi Anne Polanczyk; Christiane Corrêa Rodrigues Cimini; Daniela Antunes de Lima; Fabiano Carvalho de Sousa; Frederico Bartolazzi; Giovanna Grunewald Vietta; Heloisa Reniers Vianna; José Miguel Chatkin; Karen Brasil Ruschel; Luciane Kopittke; Luís César de Castro; Marcelo Carneiro; Priscilla Pereira dos Reis; Milena Soriano Marcolino
Source
Frontiers in Medicine, Vol 11 (2024)
Subject
Language
English
ISSN
2296-858X
Abstract
Patients with chronic kidney disease (CKD), especially those on dialysis or who have received a kidney transplant (KT), are considered more vulnerable to severe COVID-19. This susceptibility is attributed to advanced age, a higher frequency of comorbidities, and the chronic immunosuppressed state, which may exacerbate their susceptibility to severe outcomes. Therefore, our study aimed to compare the clinical characteristics and outcomes of COVID-19 in KT patients with those on chronic dialysis and non-CKD patients in a propensity score-matched cohort study. This multicentric retrospective cohort included adult COVID-19 laboratory-confirmed patients admitted from March/2020 to July/2022, from 43 Brazilian hospitals. The primary outcome was in-hospital mortality. Propensity score analysis matched KT recipients with controls - patients on chronic dialysis and those without CKD (within 0.25 standard deviations of the logit of the propensity score) - according to age, sex, number of comorbidities, and admission year. This study included 555 patients: 163 KT, 146 on chronic dialysis, and 249 non-CKD patients (median age 57 years, 55.2% women). With regards to clinical outcomes, chronic dialysis patients had a higher prevalence of acute heart failure, compared to KT recipients, furthermore, both groups presented high in-hospital mortality, 34.0 and 28.1%, for KT and chronic dialysis patients, respectively. When comparing KT and non-CKD patients, the first group had a higher incidence of in-hospital dialysis (26.4% vs. 8.8%, p