tetano
Editor, Senior Moderator
Transpl Immunol
. 2022 Dec 8;101772.
doi: 10.1016/j.trim.2022.101772. Online ahead of print.
Clinical outcomes of kidney recipients with COVID-19 (COVID-19 in kidney recipients)
Bahareh Hajibaratali[SUP] 1 [/SUP], Hossein Amini[SUP] 2 [/SUP], Nooshin Dalili[SUP] 3 [/SUP], Shadi Ziaie[SUP] 2 [/SUP], Shideh Anvari[SUP] 1 [/SUP], Elham Keykha[SUP] 4 [/SUP], Malihe Rezaee[SUP] 5 [/SUP], Shiva Samavat[SUP] 6 [/SUP]
Affiliations
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has caused significant mortality since late 2019. Patients undergoing kidney transplantation (KT) are prone to COVID-19 due to immunosuppressive drug use and various comorbidities such as hypertension and diabetes.
Methods: One hundred thirty-three KT recipients with COVID-19 were included in this retrospective cohort study. Hospital mortality was considered a primary outcome, while acute kidney injury (AKI) was considered a secondary outcome. Demographic information, maintenance immunosuppression, medical history, laboratory information, and echocardiographic and electrocardiography results of patients were recorded. Patients were also followed for 2 months post-discharge for post-COVID-19 symptoms, readmission, and transplant function.
Results: Regarding the primary outcome of the 133 patients, 13 died and 120 survived. The deceased patients were significantly older (median age, 64 vs. 50.5 years; p = 0.04) and had a significantly higher median serum creatinine level (p = 0.002) and lower median glomerular filtration rate (p = 0.010) than patients who survived. The incidence of AKI was 47.3%, more common in deceased patients (p = 0.038) than in patients who survived. Troponin levels were significantly higher in deceased patients and those with AKI (p = 0.0004 and p = 0.039, respectively) than in patients who survived and those without AKI. A multivariable Cox regression analysis revealed that older age (adjusted hazard ratio, 1.13; 95% confidence interval, 1.01-1.27) and AKI (adjusted hazard ratio, 3.43; 95% confidence interval, 1.34-8.79) were associated with in-hospital mortality.
Conclusion: In conclusion, kidney recipients with COVID-19 had a higher mortality rate than the general population, with a higher prevalence in older individuals and those who experienced AKI during hospitalization than in patients who survived and those without AKI.
Keywords: COVID-19; cardiac effects; kidney injury; kidney transplantation; mortality.
. 2022 Dec 8;101772.
doi: 10.1016/j.trim.2022.101772. Online ahead of print.
Clinical outcomes of kidney recipients with COVID-19 (COVID-19 in kidney recipients)
Bahareh Hajibaratali[SUP] 1 [/SUP], Hossein Amini[SUP] 2 [/SUP], Nooshin Dalili[SUP] 3 [/SUP], Shadi Ziaie[SUP] 2 [/SUP], Shideh Anvari[SUP] 1 [/SUP], Elham Keykha[SUP] 4 [/SUP], Malihe Rezaee[SUP] 5 [/SUP], Shiva Samavat[SUP] 6 [/SUP]
Affiliations
- PMID: 36503165
- DOI: 10.1016/j.trim.2022.101772
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has caused significant mortality since late 2019. Patients undergoing kidney transplantation (KT) are prone to COVID-19 due to immunosuppressive drug use and various comorbidities such as hypertension and diabetes.
Methods: One hundred thirty-three KT recipients with COVID-19 were included in this retrospective cohort study. Hospital mortality was considered a primary outcome, while acute kidney injury (AKI) was considered a secondary outcome. Demographic information, maintenance immunosuppression, medical history, laboratory information, and echocardiographic and electrocardiography results of patients were recorded. Patients were also followed for 2 months post-discharge for post-COVID-19 symptoms, readmission, and transplant function.
Results: Regarding the primary outcome of the 133 patients, 13 died and 120 survived. The deceased patients were significantly older (median age, 64 vs. 50.5 years; p = 0.04) and had a significantly higher median serum creatinine level (p = 0.002) and lower median glomerular filtration rate (p = 0.010) than patients who survived. The incidence of AKI was 47.3%, more common in deceased patients (p = 0.038) than in patients who survived. Troponin levels were significantly higher in deceased patients and those with AKI (p = 0.0004 and p = 0.039, respectively) than in patients who survived and those without AKI. A multivariable Cox regression analysis revealed that older age (adjusted hazard ratio, 1.13; 95% confidence interval, 1.01-1.27) and AKI (adjusted hazard ratio, 3.43; 95% confidence interval, 1.34-8.79) were associated with in-hospital mortality.
Conclusion: In conclusion, kidney recipients with COVID-19 had a higher mortality rate than the general population, with a higher prevalence in older individuals and those who experienced AKI during hospitalization than in patients who survived and those without AKI.
Keywords: COVID-19; cardiac effects; kidney injury; kidney transplantation; mortality.